血清CA153、HE4对于乳腺浸润性导管癌病理诊断的价值

目的 探讨血清糖类抗原153（CA153）、人附睾分泌蛋白4（HE4）联合检测在乳腺浸润性导管癌诊断中的价值。方法 采用化学发光免疫分析法及ELISA法检测276例乳腺浸润性导管癌、79例乳腺良性疾病患者及66例健康女性血清中CA153、HE4的含量，分析血清CA153、HE4表达水平与乳腺浸润性导管癌临床病理特征的关系。结果 CA153、HE4在乳腺浸润性导管癌组中的表达水平分别为（28.03±37.76）U/L和（105.45±95.26）pmol/L，均显著高于良性疾病组和健康对照组（P＜0.05）。两者联合检测的灵敏度为61.23％，准确性为69.60％， ROC曲线下面积（AUC）为0.759，均高于单一指标，差异有统计学意义（P＜0.05）；两者联合检测的特异度为92.41％，与单一指标的差异无统计学意义（P＞0.05）。乳腺浸润性导管癌患者血清CA153、HE4水平与是否为三阴性乳腺癌、有无淋巴结转移及临床分期有关（P＜0.05）。结论 血清CA153、HE4联合检测可作为乳腺浸润性导管癌辅助诊断指标。

The value of combined detection of serum HE4, CA153 in diagnosing breast invasive ductal carcinoma

Objective To investigate the value of combined detection of serum carbohydrate antigen 153 （CA153）and human epididymis protein 4 （HE4） in diagnosing breast infiltrative ductal carcinoma. Methods In this study， 276 breast invasive ductal carcinoma patients， 79 benign breast diseases patients and 66 healthy female volunteers were detected expressions of serum CA153 and HE4 by chemiluminescence immune analysis method and the ELISA method. The relationship between the expressions of CA153， HE4 and clinicopathological characteristics of breast infiltrative ductal carcinoma was analyzed. Results In breast invasive ductal carcinoma group， the expressions of CA153 and HE4 were （28.03±37.76）U/L and （105.45±95.26）pmol/L， which were significantly higher than benign disease group and the healthy control group （P＜0.05）. The sensitivity， accuracy， area under ROC curve（AUC） of CA153 combined with HE4 were 61.23％， 69.60％ and 0.759， which were significantly higher than single indicator（P＜0.05）. While the statistical difference of specificity was not observed（P＞0.05）. The expressions of serum CA153 and HE4 related to whether triple negative breast cancer， lymph node metastasis and clinical stage（P＜0.05）. Conclusion The combined detection of CA153 and HE4 can be the diagnosis index of breast infiltrative ductal carcinoma.