CEA与CA15-3联合检测在乳腺癌诊断中的临床意义

目的：探讨癌胚抗原（carcinoembryo antigen,CEA）与肿瘤相关糖类抗原15-3（carbohydrate antigen15-3,CA15-3）联合检测在乳腺癌诊断中的应用价值。方法：采用电化学发光方法检测116例乳腺癌患者与94例乳腺良性肿瘤患者血清中CEA与CA15-3水平并进行统计学分析。结果：乳腺癌患者血清中CEA与CA15-3水平明显高于乳腺良性肿瘤对照组（P〈0.01）;二者联合检测诊断敏感性显著提高（P〈0.05）;治疗后CEA与CA15-3含量与治疗前相比显著无明显变化（P〉0.05）。结论：CEA与CA15-3联合检测可提高乳腺癌诊断敏感性,对临床诊断与疗效评价有一定的应用价值。     

术前CEA和CA15-3对乳腺癌的临床应用价值

目的:探讨术前CEA和CA15-3对乳腺癌早期诊断的价值及其与临床病理因素的相关性。方法:回顾性分析2000年-2005年1028例乳腺癌患者的CEA、CA15-3水平以及与临床病理因素的关系。结果:CEA、CA15-3联合检测、CA15-3及CEA单独检测对乳腺癌的早期诊断敏感性均低,分别为20.9%、15.3%、9.5%;CA15-3和CEA联合检测在肝、骨和肺转移的阳性率则分别为86.7%、90.9%、45.5%(P=0.030),CA15-3、CEA单独检测对转移病灶的敏感性无差异(P均>0.05)。CEA、CA15-3单独检测及CEA、CA15-3联合检测的阳性率与乳腺癌的临床分期、T分期、N分期呈正相关性,(P均<0.001)。CEA单独检测的阳性率与年龄>45岁、绝经后、ER阴性、PR阴性、Her2阳性有显著相关性(P均<0.05);除CEA、CA15-3联合检测的阳性率与Her2阳性呈正相关,联合检测及CA15-3单独检测与其他因素无相关性。结论:术前CEA和CA15-3对乳腺癌的早期诊断缺乏敏感性,但可作为预测预后的重要指标。     

超声BI-RADS联合血CA15-3和CEA在乳腺肿物诊断中的价值研究

目的 探讨超声BI-RADS与血CA15-3和CEA联合检测在乳腺肿物中的诊断价值。方法 选择2019年6月—2019年12月乳腺肿物患者111例,以病理结果为金标准,分析超声BI-RADS、血CA15-3和CEA联合对乳腺肿物诊断的敏感性及准确性。结果 病理示良性病变43例,乳腺癌68例。与良性病变患者相比,乳腺癌患者血CA15-3和CEA均升高(P＜0.05)。乳腺癌患者CA15-3和CEA呈正相关。超声BI-RADS、血CA15-3和CEA联合对乳腺癌诊断的敏感性达到73.5%,准确性升高至83.8%,AUC提高到0.957,均高于三者各自单独使用时的诊断效果。结论 超声BI-RADS、血CA15-3和CEA联合检测是一种提高乳腺肿物诊断敏感性和准确率的有效方法。     

三维超声与MRI联合血清CA15-3、CEA诊断老年乳腺癌

目的:研究三维超声与MRI联合血清CA15-3、CEA诊断老年乳腺癌的价值,为临床诊断提供选择方案。方法:选取我院于2016年1月至2018年1月期间收治的90例确诊乳腺癌患者作为乳腺癌组,另选取同期收治的90例乳腺良性肿瘤患者作为良性组及90例来院参加健康体检的志愿者作为对照组。两组术前均进行三维超声、MRI及血清CA15-3、CEA诊断。以病理结果为标准,对比两组患者的三维超声、MRI诊断阳性率,血清CA15-3、CEA水平,联合诊断的敏感度、特异度、阳性预测值及阴性预测值,并研究联合诊断不同分期乳腺癌阳性率。结果:三组对比,乳腺癌组患者的三维超声、MRI诊断阳性率均明显高于良性组及对照组(P<0.05),且血清CA15-3、CEA水平亦高于良性组及对照组(P<0.05)。三维超声、MRI及血清CA15-3、CEA联合诊断的特异度、敏感度、阴性预测值及阳性预测值均高于单项诊断,差异均有统计学意义(P<0.05)。三维超声、MRI及血清CA15-3、CEA联合诊断Ⅰ-Ⅱ期及Ⅲ-Ⅳ期乳腺癌的阳性率高于单项诊断,差异均有统计学意义(P<0.05)。结论:三维超声与MRI联合血清CA15-3、CEA诊断老年乳腺癌,特异性及敏感性较高,联合诊断阳性率较高,且能有效诊断乳腺癌分期,值得临床借鉴。     

CEA、CA-153、ICAM-1、E-selection单项及联合检测对乳腺癌的诊断价值

目的探讨血清可溶性肿瘤标志物CEA、CA-153、ICAM-1、E-selection单项及联合检测对乳腺癌中的诊断价值。方法选取乳腺癌患者40例,将这些患者作为乳腺癌组,另选取同期收治的乳腺良性肿瘤组患者40例作为良性组,另选取同期接收的健康体检人员40例作为正常组,采用ELISA法对三组人员的血清CEA、CA-153、ICAM-1、E-selection进行连续动态检测。结果血清E-selection单项检测对乳腺癌Ⅲ期、Ⅳ期患者的敏感性较高,血清CEA单项检测对乳腺癌组患者的特异性较高;血清CEA+CA-153+ICAM-1+E-selection、CA-153+ICAM-1+E-selection对乳腺癌组患者的敏感性显著高于CEA+CA-153+ICAM-1、CEA+CA-153+E-selection、CEA+CA-153+ICAM-1+E-selection(P<0.05),血清CA-153+E-selection的敏感性显著高于CEA+CA-153、CA-153+ICAM-1(P<0.05)。结论血清可溶性肿瘤标志物CEA、CA-153、ICAM-1、E-selection联合检测在乳腺癌中具有较高的诊断价值。     

全身骨显像联合CA15-3和CEA检测对乳腺癌骨转移的诊断价值

目的 全身骨显像诊断骨转移特异性低,而肿瘤标志物测定有助于筛选临床有高风险骨转移的患者,联合两者有助于早期诊断骨转移瘤.本研究主要探讨全身骨显像联合糖类抗原15-3(carbohydrate antigen 15-3,CA15-3)和癌胚抗原(carcinoembryonic antigen,CEA)检测在乳腺癌骨转移中的诊断价值.方法 选取广西医科大学附属肿瘤医院2013-09-01-2015-07-31收治经病理确诊的90例乳腺癌患者为研究对象,回顾性分析其全身骨显像及CA15-3和CEA检测结果.参照Soloway分级标准,分析CA15-3和CEA与骨显像结果的关系;以穿刺病理及相关影像学表现为临床诊断骨转移金标准,分析并比较单项及联合检测对骨转移的诊断效能.结果 90例乳腺癌患者平均年龄(48.30士10.31)岁.病理类型分别为漫润性导管癌82例,乳腺导管内癌5例,浸润性小叶癌2例,黏液癌1例.骨转移总体发生率为62.22 ％(56/90),骨转移组血清CA15-3和CEA水平较非骨转移组高,均P＜0.001;按Soloway分级标准,M1占21.42％(12/56),M2占35.72％(20/56),M3占42.85％(24/56).全身骨显像分级与CA15-3和CEA水平之间存在强相关性,r值分别为0.794和0.757,均P＜0.001;随着级别升高,血清CA15-3和CEA水平也升高,各级之间差异有统计学意义,均P＜0.001.全身骨显像诊断乳腺癌骨转移的灵敏度、特异性和准确性分别为89.26％(50/56)、76.47％(26/34)和85.56％(77/90);CA15-3诊断骨转移的灵敏度、特异性和准确性分别为73.21％(41/56)、85.29％(29/34)和76.67％(69/90);CEA诊断骨转移的灵敏度、特异性和准确性分别为57.14％(35/56)、79.41％(27/34)和70.00％(63/90);全身骨显像联合CA15-3和CEA检测诊断骨转移的灵敏度、特异性和准确性分别为96.43％(54/56)、88.24％(30/34)和92.22％(83/90).经ROC曲线分析,联合检查曲线下面积(area under curve,AUC)为0.944,其诊断效能明显高于其他单项检查,均P＜0.05.结论 CA15-3和CEA对监测乳腺癌骨转移有一定的价值,全身骨显像联合CA15-3和CEA检测比各项单独检测更有助于乳腺癌骨转移灶的检出.     

乳腺癌血清ICTP、CA15-3水平与骨转移发生率的相关性研究北大核心CSCD

背景与目的:Ⅰ型胶原羧基端肽(carboxyterminal telopeptide of typeⅠcollagen,ICTP)为骨吸收标志物,糖类抗原15-3(carbohydrate antigen 15-3,CA15-3)属于肿瘤相关性抗原。本研究通过对乳腺癌术后患者ICTP与CA15-3水平的定期检测,并随访观察,探讨ICTP与CA15-3水平与乳腺癌骨转移发生率的相关性。方法:对61例乳腺癌术后患者定期检测血清ICTP与CA15-3水平,术后第1年每个月检测1次,第2年每2个月1次,第3年每3个月1次。观察临床分期与血清ICTP与CA15-3阳性率的关系,评估联合检测血清ICTP、CA15-3对乳腺癌骨转移的诊断价值。结果:临床分期Ⅰ、Ⅱ期ICTP与CA15-3阳性升高率低,Ⅲ、Ⅳ期阳性升高率明显增高,各分期比较差异有统计学意义(P<0.05)。随着血清ICTP、CA15-3水平升高,各个区段骨转移发生率之间差异有统计学意义(P<0.01);两者均与骨转移发生有良好相关性(P<0.01),且两者之间呈中度相关。61例中有27例ICTP、CA15-3均升高并呈阳性,其中有21例出现临床骨转移症状,占77.78%;在11例ICTP与CA15-3均为阴性的术后患者中,有1例出现临床骨转移症状及相关证据,占9.01%;两者相比差异有统计学意义(P<0.01)。ICTP与CA15-3联合检测对乳腺癌骨转移诊断的敏感性、特异性及阳性预测值、阴性预测值均高于单独检测。结论:定期检测乳腺癌术后患者血清ICTP与CA15-3,对预测骨转移有重要的临床应用价值。     

应用ROC曲线分析评价肿瘤标志物糖类抗原15-3、癌胚抗原在乳腺癌诊断与术后监测中的价值

目的评价肿瘤标志物糖类抗原15-3(carbohydrate antigen,CA15-3)、癌胚抗原(carcino-embryonic antigen,CEA)在乳腺癌诊断与术后复发转移判断中的应用价值。方法采用化学发光免疫分析法测定110例乳腺癌患者、50例乳腺良性疾病患者及40例正常对照者的血清CA15-3、CEA水平。组间比较采用χ2检验。用ROC曲线评价CA15-3、CEA在乳腺癌诊断和术后复发转移判断中的应用价值。结果 110例患者中CA15-3和CEA阳性检出率分别为32.7%(36/110)和12.7%(14/110)。I期、II期乳腺癌患者CA15-3、CEA血清含量无明显变化,与良性组和正常对照组相比差异无统计学意义(P0.050)。以43例Ⅲ期、Ⅳ期乳腺癌患者的CA15-3、CEA测定值绘制ROC曲线,分析显示,CA15-3、CEA的ROC曲线下面积(AUC)分别为82.3%、81.1%,95%可信区间分别为0.719～0.929、0.714～0.906。术后复发转移患者CA15-3、CEA阳性检出率分别为85.7%(18/21)、52.4%(11/21),AUC分别为97.8%、89.1%,95%可信区间分别为0.944～1.011、0.790～0.991。结论通过ROC曲线评价可得出,CA15-3、CEA对Ⅲ期、Ⅳ期乳腺癌诊断有临床参考价值,在术后复发转移诊断中有较高的应用价值,可作为乳腺癌术后监测复发转移的有效指标。     

乳腺癌患者血清可溶性肿瘤标志物的临床价值研究

目的:探讨血清可溶性肿瘤标志物CEA、CA-153、ICAM-1、E-selection单项及联合检测在乳腺癌中的诊断价值.方法:选取不同临床分期乳腺癌患者130例.乳腺良性肿瘤患者30例,正常人群30例.通过酶联免疫吸附法(ELISA)测定各项指标血清浓度并进行比较.结果:乳腺癌CEA、CA-153、ICAM-1、E-selection血清浓度均显著高于良性肿瘤组及正常人群(P<0.01),且其血清浓度与肿瘤分期密切相关.在疾病进展的转移性乳腺癌中,各指标出现明显升高(P<0.01).CEA、CA-153、ICAM-1、E-selection单项检测对于乳腺癌的诊断敏感性较低.多指标联合检测可不同程度提高检测的敏感性,以含CA-153及E-selection组合最为显著.结论:E-selection、ICAM-1、CEA、CA-153均为乳腺癌重要的血清标志物,在肿瘤的发生、发展及转移过程中发挥重要的作用.对恶性肿瘤患者的多指标联合检测可在不显著降低特异性的基础上提高诊断的敏感性,为判断预后及监测病情提供重要价值.     

甲胎蛋白、癌胚抗原和糖链抗原19-9联合检测诊断消化系统恶性肿瘤的价值分析

目的 探讨甲胎蛋白(AFP)、癌胚抗原(CEA)和糖链抗原19-9(CA19-9)联合检测对消化系统恶性肿瘤的诊断价值.方法 回顾性分析300例消化系统恶性肿瘤患者和108例消化系统良性病变患者的临床资料,记录患者的血清AFP、CEA和CA19-9水平,评价其诊断效能.结果 肝癌患者的血清AFP、CEA和CA19-9水平均高于肝硬化患者,胃癌、胰腺癌和结直肠癌患者的血清CEA和CA19-9水平分别高于胃溃疡、胰腺炎和溃疡性结肠炎患者,差异均有统计学意义(P<0.05).单项检测中,AFP对肝癌的诊断敏感度(78.5%)高于CEA和CA19-9(P<0.05);CA19-9对胰腺癌的诊断敏感度(78.2%)高于AFP和CEA(P<0.05).对于肝癌、胃癌、胰腺癌和结直肠癌,3项联合检测的敏感度均高于单项检测(P<0.05).结论 血清AFP、CEA和CA19-9联合检测对消化系统恶性肿瘤的早期诊断具有重要意义,可提高诊断的敏感度,且不会降低特异度.     

The value of the tumor marker CA 15-3 in diagnosing and monitoring breast cancer. A comparative study with carcinoembryonic antigen

To estimate the utility of the tumor-associated antigen CA 15-3 in the diagnosis of patients with breast cancer, this tumor marker was measured preoperatively in 1342 patients. This group included 509 patients with malignant disease (134 breast cancer patients and 375 patients with other malignancies not involving the breast) and 833 patients with benign surgical diseases (95 patients with fibroadenoma of the breast and 738 patients with other benign diseases). The results were compared with those obtained for carcinoembryonic antigen (CEA) in the diagnosis of breast cancer. The CA 15-3 level was above normal (25 U/ml) in 31% of the patients with breast cancer, in 22% of patients with other malignancies, and in 9% of patients with benign diseases. The CEA level was elevated in 26% of patients with breast cancer (more than 3 ng/ml). There was a good correlation of CA 15-3 levels with the tumor stage of breast cancer. Both CA 15-3 and CEA also were determined in 671 patients who had received initial curative surgery of breast cancer and who regularly attended our follow-up clinic. The CA 15-3 was found to be more sensitive than CEA in detecting recurrences of breast cancer. In the postcare period, carcinoma recurred in 205 patients. Of these, 73% had CA 15-3 concentrations above 25 U/ml; only 50% had CEA values above 3 ng/ml (P less than 0.0001). Although neither CA 15-3 nor CEA were sensitive enough for the screening and diagnosis of early breast cancer, CA 15-3 was significantly better than CEA in the detection of breast cancer metastases.     

糖类抗原15-3、癌胚抗原、环氧合酶-2联合检测在乳腺癌诊断中的应用

 目的　探讨糖类抗原15-3（CA15-3）、癌胚抗原（CEA）、环氧合酶-2（COX-2）联合检测对乳腺癌早期诊断的应用价值。方法　选择经影像学和病理学诊断为乳腺癌患者53例,同时选择同期良性乳腺病患者61例及同期健康体检者68名,采用电化学发光技术与酶联免疫吸附法（ELISA）分别检测血清CA15-3、CEA、COX-2水平。结果　乳腺癌组CA15-3、CEA、COX-2血清水平分别为（34.67±13.20）U／ml、（7.38±3.87）ng／ml、（43.25±10.87）ng／ml,与良性乳腺病组和健康对照组血清含量比较差异具有统计学意义（均P＜0.01）;CA15-3、CEA、COX-2联合检测将各项指标单独检测的阳性检出率提高至84.9 %（45／53）,其敏感度提高至84.9 %,准确度提高至91.2 %。结论　三项肿瘤标志物联合应用能弥补单项肿瘤标志物临床应用的不足,对提高乳腺癌阳性检出率具有一定意义。     

乳腺癌肿瘤标志物CEA、CA15-3表达水平的临床意义

目的:探讨血清CEA、CA15-3与乳腺癌临床诊断方面的关系.方法:应用微粒子免疫萤光技术对210例乳腺癌患者、75例乳腺良性疾病患者及50例正常对照者血清CEA CA15-3表达水平进行检测比较.结果:CEA、CA15-3在乳腺癌Ⅲ、Ⅳ期中表达明显增高(P＜0.005),在Ⅰ、Ⅱ期中表达与正常组及良性疾病组比较无显著性差异(P＞0.05).两种标志物与肿瘤分期、淋巴结受累程度有关,腋淋巴结转移≥4枚或远处脏器转移时CEA、CA15-3浓度明显增高(P＜0.005).两种标志物与肿瘤病理学分型的关系不明显(P＞0.05).乳腺癌术后动态监测CEA、CA15-3对肿瘤远处转移呈高表达(P＜0.005),对局部复发CEA无显著性(P＞0.05),而CA15-3有指导意义(P＜0.005).结论:CEA、CA15-3并非乳腺癌早期诊断的理想标志物,但其与肿瘤临床分期、淋巴结转移程度、远处转移关系密切,是乳腺癌术前预测转移及监测术后复发转移与评估乳癌预后的有效指标.     

Circulating CA 15-3 levels in the postsurgical follow-up of breast cancer patients and in non-malignant diseases

Summary Circulating CA 15-3 antigen levels were evaluated in patients with benign diseases and breast cancer patients with no clinical evidence of disease after surgery (NED). Patients with breast cancer NED were followed for tumor recurrence or death during a median of 12.9 months (range 1 to 25 months). CA 15-3 and carcinoembryonic antigen (CEA) were compared in the same breast cancer NED patient population. Elevated CA 15-3 levels (>40 U/ml) were observed in 38 of 1220 patients with benign diseases (3.1%) and in 25 of 350 breast cancer NED patients (7.1%). Elevations of CEA (>5ng/ml) were observed in 23 patients with breast cancer NED (6.5%). Benign diseases that produced significant elevations of CA 15-3 were chronic hepatitis (42.9%), liver cirrhosis (13.3%), sarcoidosis (16.7%), tuberculosis (9.7%), and systemic lupus erythematosous (6.7%).In breast cancer NED, initial elevations of CA 15-3 were observed in 12 of the 297 patients that remained free of disease during the follow-up, and in 13 of the 40 patients that relapsed (4.0% vs. 32.5%, p<0.001). Initial CEA levels were elevated in 16 patients that remained NED and in 7 patients that relapsed (5.3% vs. 17.5%, p<0.001). Serial determinations of CA 15-3 in patients continuously NED showed persistent elevations in 4 cases. Three of these exhibited concomitant benign diseases. In relapsing patients, serial tumor marker determinations showed that elevations of CA 15-3 before any other clinical evidence of recurrence occurred significantly more frequently than elevations of CEA (45% vs. 25%, p<0.001). Overall, two or more serial elevated values of CA 15-3 were observed in 7 cases, and 6 of them (85%) eventually relapsed. Median survival from study entry was 18.3 months in patients with breast cancer NED that had initial elevated CA 15-3, compared to 25+ months in those with negative CA 15-3 (p<0.0001).We conclude that circulating levels of CA 15-3 antigen can be elevated in some patients with nonmalignant diseases, and that serial determinations of CA 15-3 may be useful in the postsurgical follow-up of patients with breast cancer when specific types of benign diseases that may cause elevations of the antigen are excluded. Additionally, CA 15-3 is more sensitive than CEA in the early diagnosis of breast cancer recurrences, and the simultaneous assay of CEA does not add information to that of CA 15-3 alone.     

CEA、CA199、CA125、CA724联合检测对胃癌的临床诊断价值

目的 探讨肿瘤标记物CEA、CA199、CA125、CA724联合检测对胃癌的临床诊断价值.方法 选取126例胃癌患者,94例胃部良性病变患者,根据疾病类型分组,胃癌组(126例)和良性病变组(94例),另选50例健康体检患者作为对照组.应用全自动电化学发光免疫分析仪,测定不同临床分期患者血清肿瘤标志物含量水平.结果 胃癌组血清CEA、CA199、CA125、CA724水平明显高于良性病变组和对照组患者(P<0.05),良性病变组上述指标也高于对照组(P<0.05);Ⅲ、Ⅳ期胃癌患者血清CEA、CA199、CA125、CA724含量明显高于Ⅰ、Ⅱ期胃癌患者;胃癌患者CEA、CA199、CA125、CA724检测阳性率明显高于良性病变组和对照组(P<0.05),良性病变组上述指标的阳性率也高于对照组患者(P<0.05),联合检测为CEA、CA199、CA125、CA724四项指标共同检测,对3组的检测阳性率均高于单项检测阳性率(P<0.05).结论 与良性病变、对照组相比,血清CEA、CA199、CA125、CA724在胃癌中含量较高,且随着胃癌病情程度加深,上述指标血清含量增加.将4种肿瘤标志物联合检测比单一检测更具诊断价值.     

核素骨显像联合肿瘤标记物检测对乳腺癌骨转移的诊断价值

目的：观察核素骨显像联合肿瘤标记物对乳腺癌骨转移的诊断价值。方法选择乳腺癌患者82例,按照核素骨显像结果分为转移组43例及未转移组39例,另选取40例健康体检女性作为对照组。观察核素骨显像以及肿瘤标记物检测结果,并对其诊断价值进行考察。结果转移组血清CA125、CA15-3及CEA表达水平及阳性率显著高于未转移组及对照组,骨转移灶数目≤2患者血清CA125、CA15-3以及CEA表达水平及阳性率均显著低于骨转移灶数目＞2的患者,差异均具有统计学意义（P＜0．05）。且随着骨转移分级程度的升高,患者乳腺癌相关肿瘤标记物CA125、CA15-3及CEA表达水平及阳性率均呈升高趋势,各分级间差异有统计学意义（ P＜0．05）。结论核素骨显像联合肿瘤标记物检测可提高诊断敏感性,对于乳腺癌骨转移的诊断具有重要的参考价值。