血清三种肿瘤标志物对乳腺癌诊断的临床研究

目的建立一种检测乳腺癌患者血清中恶性肿瘤特异性生长因子(TSGF)、糖类抗原15-3(CA15-3)和癌胚抗原(CEA)的方法,用以诊断乳腺癌。方法用生化比色法和电化学发光技术分别检测正常人、乳腺纤维瘤及乳腺癌患者的TSGF、CA15-3和CEA含量。结果TSGF诊断乳腺癌的敏感性、特异性分别为79.1%和86.4%,阳性预测值94.5%。CA15-3的敏感性、特异性分别为68.3%和96.8%,阳性预测值98.5%。CEA的敏感性、特异性分别为42.0%和95.2%,阳性预测值96.3%。TSGF、CA15-5与CEA阳性似然比依次为5.8、21.3和6.6,阴性似然比依次为0.2、0.2和0.6。三项指标均为阳性时,则敏感性为41.5%,但特异性及阳性预测值均为100%。与其临床分期呈正相关,其含量T4>T3>T2>T1,且T4、T3明显高于T1、T2期,表明三项肿瘤指标与乳腺肿瘤的大小具有相关性。结论采用TSGF、CA15-3和CEA联合检测可提高对乳腺癌诊断的特异性和有效性,也是评估乳腺癌患者预后的有效指标。

Clinical analysis of TSGF, CA15-3 and CEA in diagnosis of breast neoplasm

Objective To establish a method to detect the expressions of TSGF(the tumor specific growth factor), CA15-3 and CEA in serum and evaluate their value in the diagnosis of breast neoplasm. Methods ELISA and biochemical colorimetric assay were used to detect the serum contents of TSGF, CA15-3 and CEA in 125 normal cases, 369 breast neoplasm patients and 52 breast fibroma patients. Results The positive likelihood ratios of TSGF, CA15-3 and CEA were 5.8, 21.3 and 6.6, and their negative likelihood ratios were 0.2, 0.2 and 0.6, respectively. With single tumor marker diagnosed breast neoplasm, the highest sensitivity and specificity of TSGF were 79.1% and 86.4%. In combined test with three markers, when all of them were positive, the sensitivity changed to 41.5%, and the specificity and positive predictive value were 100%. Conclusion The combined use of TSGF, CA15-3 and CEA expressions can elevate the specificity for breast neoplasm diagnosis.