3项肿瘤标志物在乳腺癌中的临床诊断价值

Clinical diagnostic value of the three tumor markers in breast cancer

目的探讨血清肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)在西藏自治区藏族乳腺癌人群中的临床诊断价值。方法选取2018年1月至2022年1月在西藏自治区人民医院行乳腺检查的192例女性为研究对象,包括乳腺癌患者80例(恶性组)、乳腺良性肿瘤患者56例(良性组)和健康体检者56例(健康组)。采用化学发光微粒子免疫法检测各组血清CEA、CA125及CA153的水平并进行对比分析,同时评估血清CEA、CA125、CA153单独及联合检测对乳腺癌的诊断价值。结果恶性组血清CEA、CA125、CA153水平高于良性组和健康组,且良性组血清CEA、CA125和CA153水平高于健康组,差异均有统计学意义(P<0.05);恶性组血清CEA、CA125、CA153阳性检出率高于良性组,且3项指标联合检测的阳性检出率高于各指标单独检测,差异均有统计学意义(P<0.05)。血清CEA、CA125、CA153联合检测诊断乳腺癌的曲线下面积高于CEA、CA125单独检测(P<0.05)。在不同肿瘤临床分期及腋窝淋巴结有无转移的乳腺癌患者间血清CEA、CA125、CA153的阳性检出率比较,差异均有统计学意义(P<0.05)。结论血清CEA、CA125、CA153联合检测可提高西藏藏族女性乳腺癌的检出率,在藏族女性乳腺癌患者中动态监测血清CEA、CA125和CA153的水平,对明确病情进展有一定辅助作用。

Objective To investigate the diagnostic value of combined detection of three serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA153)]in breast cancer in Tibetan populations in Tibet.Methods A total of 192 women who underwent breast examination in the People′s Hospital of Tibet Autonomous Region from January 2018 to January 2022 were selected as the study subjects,including 80 cases of breast cancer patients(malignant group),56 cases of benign breast tumors(benign group)and 56 cases of healthy medical checkups(healthy group).The levels of serum CEA,CA125 and CA153 in the three groups were detected by chemiluminescence microparticle immunoassay and analyzed comparatively,and the diagnostic values of serum CEA,CA125 and CA153 alone and in combination for breast cancer were evaluated.Results The levels of serum CEA,CA125 and CA153 in the malignant group were higher than those in the benign group and healthy group,while the levels of serum CEA,CA125 and CA153 in the benign group were higher than those in the healthy group,and the differences were statistically significant(P<0.05).The positive detection rates of serum CEA,CA125 and CA153 in the malignant group were higher than those in the benign group,and the positive detection rate of the combined test of the three indicators was higher than that of the single test of each indicator,and the differences were statistically significant(P<0.05).The area under the curve of the combined diagnosis of breast cancer by serum CEA,CA125 and CA153 was higher than that of serum CEA and CA125 alone(P<0.05).The positive detection rate of serum CEA,CA125 and CA153 between different tumor clinical stages and whether lymph nodes were metastatic or not had statistical significant difference(P<0.05).Conclusion The combined detection of serum CEA,CA125 and CA153 can improve the detection rate of breast cancer in Tibetan women in Tibet,dynamic monitoring of the expression levels of serum CEA,CA125 and CA153 in Tibetan female patients with breast cancer is helpful to clarify the progression of the disease.