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    肿瘤标志物联合检测在乳腺癌临床诊断中的应用

    Clinical application of combined detection of tumor markers in the diagnosis of breast cancer

      摘要
    • 摘要: 目的：探讨联合检测血清中乳腺癌抗原（CA15-3）、癌胚抗原（CEA）、恶性肿瘤特异性生长因子（TSGF）、卵巢癌相关抗原（CA125）、人生长分化因子 3（GDF3）水平对乳腺癌的临床诊断价值。方法：选取56例原发性乳腺癌病人为乳腺癌组，同期治疗的44例良性乳腺肿瘤病人为良性组，同期体检的52名健康女性为对照组，所有受试者均于清晨空腹状态时采集3 mL外周静脉血，离心分离血清，CA15-3、CA125、CEA均采用化学发光法检测，TSGF 采用化学比色法检测，GDF3采用酶联免疫吸附试验法检测。结果：乳腺癌组病人5项血清肿瘤标志物检测结果均明显高于良性组和对照组（P<0.01）。良性组除TSGF 明显高于对照组 （P<0.01），其余4项血清肿瘤标志物检测结果与对照组比较差异均无统计学意义（P>0.05）。CA15-3、CEA、TSGF、CA125、GDF3单独检测对乳腺癌的灵敏度分别为32.1%、26.8%、21.4%、17.9%、16.1%，联合检测的灵敏度为64.3%，均高于任一肿瘤标志物单独检测（P<0.05）。CA15-3、CEA、TSGF、CA125、GDF3单独检测对乳腺癌的特异度分别为88.6%、97.7%、77.3%、68.2%、77.3%，联合检测的特异性为72.7%，CEA单独检测特异性最好，且高于TSGF、CA125、GDF3单独检测（P<0.05） 。CA15-3、CEA、TSGF、CA125、GDF3单独检测对乳腺癌的准确度分别为57.0%、58.0%、46.0%、40.0%、43.0%，联合检测的准确度为68.0%，高于TSGF、CA125、GDF3单独检测（P<0.05）。结论：肿瘤标志物联合检测在临床乳腺癌诊断中具有较单一肿瘤标志物更高的灵敏度和准确度，可降低临床漏诊率，具有重要的临床应用价值。

       

      Abstract: Objective:To investigate the clinical value of combined detection of the serum cancer antigen15-3(CA15-3),carcinoembryonic antigen(CEA),tumor specific growth factor(TSGF),cancer antigen125(CA125) and growth differentiation factor 3(GDF3) in the diagnosis of breast cancer.Methods:Fifty-six patients with primary breast cancer,44 patients with benign breast tumor and 52 healthy females were divided into the breast cancer group,benign group and control group,respectively.The 3ml peripheral blood of fasting state in all cases was collected,and centrifuged.The serum levels of CA15-3,CA125 and CEA were detected by chemiluminescence method,the TSGF was detected by chemical colorimetric method,and GDF3 was detected by enzyme linked immunosorbent assay.Results:The serum levels of five tumor markers in breast cancer group were significantly higher than those in benign group and control group(P<0.01).Except for the level of TSGF in benign group were significantly higher than that in control group(P<0.01),and the differences of the levels of other four markers between benign group and control group were not statistically significant(P>0.05).The sensitivities of the separate detection of CA15-3,CEA,TSGF,CA125 and GDF3 were 32.1%,26.8%,21.4%,17.9% and 16.1%,respectively,and the sensitivity of combined detection was 64.3%,and higher than that of one tumor marker detection(P<0.05).The specificities of the separate detection of CA15-3,CEA,TSGF,CA125 and GDF3 were 88.6%,97.7%,77.3%,68.2% and 77.3%,respectively,and the specificity of combined detection was 72.7%.The specificity of CEA detection was the best,and which was higher than that of GdF3,CA125 and TSGF detection alone(P<0.05).The accuracies of the separate detection CA15-3,CEA,TSGF,CA125 and GDF3 were 57.0%,58.0%,46.0%,40.0% and 43.0%,respectively.The accuracy of combined detection was 68.0%,and which was higher than that of GDF3,CA125 and TSGF detection alone(P<0.05).Conclusions:The combined detection of tumor markers in the diagnosis of breast cancer has more higher sensitivity and accuracy,which can reduce the clinical misdiagnosis rate,and has important clinical application value.

       

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