乳头溢液肿瘤标记物癌胚抗原、糖类抗原153、糖类抗原125联合检测在乳腺癌诊断中的价值

The value of combined detection of CEA,CA153 and CA125 in nipple discharge in the diagnosis of breast cancer

目的:探讨乳头溢液肿瘤标记物癌胚抗原(Carcinoembryonic Antigen,CEA)、糖类抗原153(Carbohydrate Antigen153,CA153)、糖类抗原125(Carbohydrate Antigen 125,CA125)联合检测在乳腺癌诊断中的临床应用价值。方法:收集92例乳腺浸润性导管癌伴乳头溢液患者(乳腺癌组)、50例乳腺导管增生病变伴有乳头溢液患者(良性对照组)为研究对象;电化学发光法检测两组患者乳头溢液和血清CEA、CA153、CA125水平;以病理诊断为金标准,用四格表法统计分析乳头溢液CEA、CA153、CA125联合检测诊断乳腺癌的价值。结果:乳腺癌组乳头溢液和血清CEA、CA153、CA125水平均明显高于良性对照组,且乳腺癌组中乳头溢液CEA、CA153、CA125水平明显高于血清CEA、CA153、CA125水平(均P<0.01);乳腺癌患者乳头溢液CEA、CA153、CA125表达水平与对应血清CEA、CA153、CA125表达水平呈明显正相关性(r=0.872、0.789、0.843),P<0.01;乳腺癌组乳头溢液CEA、CA153、CA125水平与患者年龄、肿瘤部位无明显相关性(P>0.05),与肿瘤大小、分化程度、临床分期、转移、复发明显相关(P<0.01);肿瘤直径>2 cm、低分化、高分期、转移、复发患者乳头溢液CEA、CA153、CA125水平明显高于肿瘤直径≤2 cm、高中分化、低分期、无转移、无复发患者乳头溢液CEA、CA153、CA125水平;乳头溢液CEA、CA153、CA125三项联合检测诊断乳腺癌的敏感性、准确性、阴性预测值与各单项及血清组合检测比较明显提高(P<0.01),分别为94.57%(87/92)、92.25%(131/142)、89.80%(44/49)。结论:乳头溢液CEA、CA153、CA125联合检测对伴有乳头溢液乳腺癌早期诊断供了新思路,明显提高了乳腺癌诊断价值。

Objective:To investigate the clinical application value of the combined detection of carcinoembryonic antigen(CEA),carbohydrate antigen 153(CA153)and carbohydrate antigen 125(CA125)in the diagnosis of breast cancer.Methods:A total of 92 cases of breast invasive ductal carcinoma with nipple discharge(the breast cancer group)and 50 cases of breast ductal hyperplasia with nipple discharge(the benign control group)were collected as the research objects.The nipple discharge and serum CEA,CA153,O CA125 levels in the two groups of patients were detected by electrochemiluminescence method.With pathological diagnosis as the gold standard,the value of nipple discharge CEA,CA153,CA125 joint detection in the diagnosis of breast cancer was statistically analyzed by four grid method.Results:The levels of CEA,CA153,CA125 in nipple discharge and serum in breast cancer group were significantly higher than those in benign control group,and the levels of CEA,CA153,CA125 in nipple discharge in breast cancer group were significantly higher than those of corresponding in the breast cancer group(all P<0.01).The expression levels of CEA,CA153,CA125 in nipple discharge of breast cancer patients were positively correlated with the corresponding serum expression levels(r=0.872,0.789,0.843),P<0.01.In the breast cancer group,the levels of CEA,CA153 and CA125 in nipple discharge were not significantly correlated with the patient’s age and tumor site(P>0.05),but were significantly correlated with tumor size,differentiation degree,clinical stage,metastasis and recurrence(P<0.01).The levels of CEA,CA153 and CA125 in nipple discharge of patients with tumor diameter>2 cm,low differentiation,high staging,metastasis and recurrence were significantly higher than those of patients with tumor diameter≤2 cm,high differentiation,low staging,and no metastasis and recurrence.The sensitivity,accuracy and negative predictive value of the combined detection of CEA,CA153 and CA125 in nipple discharge in the diagnosis of breast cancer were significantly higher than those of single and serum combined detection(P<0.01),which were 94.57%(87/92),92.25%(131/142)and 89.80%(44/49)respectively.Conclusion:The combined detection of CEA,CA153 and CA125 in nipple discharge provides a new idea for the early diagnosis of breast cancer with nipple discharge,and significantly improves the diagnostic value of breast cancer.