CH3L1、CEA及CA15-3联合检测在乳腺癌诊断中的应用价值

目的 探讨血清壳多糖酶3样蛋白1(chitinase-3-like protein 1,CHI3L1)、癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原15-3(carbohydrate antigen 15-3,CA15-3)单一检测及联合检测在乳腺癌诊断中的临床应用价值。方法 选取乳腺癌确诊患者88例,乳腺良性病变40例,30例同期健康体检者为研究对象,采用定量酶联免疫吸附法测定血清CHI3L1水平,化学发光法测定血清CEA、CA15-3水平。应用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析CHI3L1、CEA、CA15-3单一检测及联合检测在乳腺癌诊断中的应用价值。结果 乳腺癌肿瘤大小分组中T3+T4组CHI3L1浓度高于T1+T2组,差异有统计学意义(P＜0.05);有远处转移组 CHI3L1浓度高于无远处转移组,差异有统计学意义(P＜0.05)。乳腺癌组的血清浓度CHI3L1、CEA、CA15-3明显高于良性组和对照组(P=0.000),差异有统计学意义。CHI3L1、CEA、CA15-3单项指标检测时曲线下面积(area under curve,AUC)分别为0.879、0.708、0.778,三项联合检测时AUC为0.956,明显高于各项单项检测指标。结论 血清CHI3L1、CEA、CA15-3联合检测对乳腺癌的诊断有重要参考价值,提高了乳腺癌的诊断效能。

Application value of combined detection of serum chitinase-3-like protein 1, carcino-embryonic antigen and carbohydrate antigen 15-3 in diagnosing breast cancer

Objective To explore the clinical application values of serum chitinase-3-like protein 1(CHI3L1),carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA15-3) detection used alone or in combination for thediagnosis of breast cancer. Methods Eighty-eight patients with breast cancer, 40 patients with benign breast diseases and 30 physical examinees were selected as the research subjects. Quantitative enzyme-linked immunosorbent assay was used to detect the serum level of CHI3L1, and chemiluminescence assay to detect the serum levels of CEA and CA15-3. Receiver operating characteristic (ROC) curve was employed to assess the application values of the above-mentioned indexes applied alone or in combination for the diagnosis of breast cancer. Results As for the breast cancer groups based on tumor size, the serum CHI3L1 level was significantly higher in the T3+T4 group than in the T1+T2 group, showing a statistically significant difference (P<0.05). The serum CHI3L1 level was significantly higher in the group with distant metastasis than in the group without distant metastasis, showing a statistically significant difference (P<0.05). The serum levels of CHI3L1, CEA and CA15-3 were significantly higher in the breast cancer group than in the benign breast disease group as well as the control group, with statistically significant differences (P=0.000). The area under ROC curve (AUC) of detection of CHI3L1, CEA and CA153 used alone was 0.879, 0.708 and 0.778, respectively. The AUC of combined detection of CHI3L1, CEA and CA153 was 0.956, which was significantly higher than the AUC of detection of CHI3L1, CEA and CA153 used alone. Conclusions The combined detection of serum CHI3L1, CEA and CA15-3 has important reference value for the diagnosis of breast cancer; moreover, it improves the diagnostic efficiency of breast cancer.