彩色多普勒超声结合血清CA153、MUC1、GDF3对早期乳腺癌的诊断价值研究

Diagnostic Value Study of Color Doppler Ultrasound Combined with Serum CA153,MUC1 and GDF3 in Early Breast Cancer

目的:分析彩色多普勒超声结合血清糖类抗原153(CA153)、黏蛋白1(MUC1)、人生长分化因子3(GDF3)对早期乳腺癌的诊断价值。方法:选取2019年1月至2022年10月我院收治的105例乳腺癌患者(乳腺癌组)。另选取我院同期收治的乳腺良性疾病患者94例(良性组)及体检健康女性91例(对照组)。三组均进行彩色多普勒超声和CA153、MUC1、GDF3水平检查,并以临床病理诊断为金标准,分析彩色多普勒超声、血清CA153、MUC1、GDF3单独及联合对早期乳腺癌的诊断价值。结果:对照组超声双侧乳腺的轮廓清晰,未见明显的增厚,腺体结构未见明显异常改变,回声均匀。乳腺癌组纵横比≥1、血流分级Ⅱ-Ⅲ级、肿瘤形态不规则、后方回声衰减、边界模糊、有微小钙化、有毛刺征所占比例高于良性组(P<0.05)。乳腺癌组血清CA153、MUC1、GDF3水平均高于对照组和良性组(P<0.05),且良性组高于对照组(P<0.05)。乳腺癌组血清CA153、MUC1、GDF3和彩色多普勒超声及4项联合检测阳性率明显高于良性组和对照组(P<0.05),良性组和对照组CA153、MUC1、GDF3及4项联合检测阳性率比较差异无统计学意义(P>0.05),而良性组彩色多普勒超声检出阳性率高于对照组(P<0.05)。3项血清标志物中CA153的灵敏度、特异度、准确度最高为52.38%、89.73%、76.21%,彩色多普勒超声的灵敏度、特异度、准确度分别为84.76%、83.24%、83.79%,4项联合的灵敏度、准确度最高为94.28%,88.27%,特异度为84.86%。结论:CA153、MUC1、GDF3在乳腺癌患者中均呈现高水平状态,彩色多普勒超声联合上述3类指标检测可提高对早期乳腺癌的诊断效能。

Objective:To analyze the diagnostic value of color Doppler ultrasound combined with serum carbohydrate antigen 153(CA153),mucin 1(MUC1)and human growth differentiation factor 3(GDF3)in early breast cancer.Methods:105 breast cancer patients(breast cancer group)who were admitted to our hospital from January 2019 to October 2022 were selected.In addition,94 patients with benign breast diseases(benign group)who were admitted to our hospital during the same period and 91 healthy women in physical examination(control group)were selected.Color Doppler ultrasound and CA153,MUC1 and GDF3 levels were performed in all three groups.The clinicopathological diagnosis was taken as the gold standard,and the diagnostic value of color Doppler ultrasound,serum CA153,MUC1 and GDF3 alone and in combination in early breast cancer were analyzed.Results:In the control group,the contour of bilateral mammary glands was clear,no obvious thickening was found,the gland structure was not significantly abnormal,and the echo was uniform.The ratio of aspect ratio≥1,gradeⅡ-Ⅲblood flow grade,irregular tumor shape,attenuation of posterior echo,blurred boundary,micro calcification and burr sign in the breast cancer group were higher than those in the benign group(P<0.05).The CA153,MUC1and GDF3 levels in the breast cancer group were higher than those in the control group and benign group(P<0.05),and the benign group was higher than the control group(P<0.05).The positive rates of CA153,MUC1,GDF3 and color Doppler ultrasound and the 4 items combined tests in the breast cancer group were significantly higher than those in the benign group and control group(P<0.05),but there were no significant differences between the positive rates of the benign group and control group in CA153,MUC1,GDF3 and the 4 items combined tests(P>0.05).The positive rate of color Doppler ultrasound in the benign group was higher than that in the control group(P<0.05).Among the 3 items serum markers the sensitivity,specificity and accuracy of CA153 were the highest of 52.38%,89.73%and76.21%,the sensitivity,specificity and accuracy of color Doppler ultrasound were 84.76%,83.24%and 83.79%,respectively.the sensitivity and accuracy of the 4 items combined were the highest of 94.28%,88.27%,the specificity was 84.86%.Conclusion:CA153,MUC1 and GDF3 all present high levels in breast cancer patients.Color Doppler ultrasound combined with the above 3 indexes can improve the diagnostic effect of early breast cancer.