血清肿瘤抗原15-3、恶性肿瘤特异性生长因子、骨桥蛋白和肿瘤抗原125联合检测在乳腺癌诊断和治疗中的价值

 【摘要目的　探讨血清肿瘤标志物[肿瘤抗原15-3（CA15-3）、恶性肿瘤特异性生长因子（TSGF）、骨桥蛋白（OPN）和肿瘤抗原125（CA125）]联合检测在乳腺癌诊断和治疗中的价值。方法　采用电化学发光法检测患者血清CA15-3和CA125、化学比色法检测TSGF及酶联免疫吸附试验法检测OPN水平，乳腺癌组（187例）与乳腺疾病良性对照组（50例）患者比较，分析各标志物与乳腺癌临床分期和复发转移的关系。对45例复发者比较血清肿瘤标志物与钼靶X线检出时间的差异。结果　乳腺癌组患者血清CA15-3、CA125、TSGF和OPN明显高于良性对照组（P＜0.01）；乳腺癌高分期（Ⅲ、Ⅳ期）组[四项指标分别为（83.21±28.67）、（89.13±32.42）、（278.66±137.23）U／ml和（97.4±11.7）ng／ml]明显高于良性对照组[（14.01±3.23）、（13.12±9.23）、（46.15±3.12）U／ml和（30.12±12.91）ng／ml]和低分期（Ⅰ、Ⅱ期）组[（60.03±19.35）、（58.21±17.46）、（155.79±113.11）U／ml和（77.5±10.81）ng／ml]（P＜0.05）；淋巴结转移组与无转移组、复发组与无复发组间差异有统计学意义（P＜0.05）；CA15-3、TSGF、OPN和CA125联合检测的敏感度为96.3 %（180／187），特异度为80.0 %（40／50）；复发组血清肿瘤标志物检测比钼铑双靶X线检测出肿块时间平均早2个月。结论　CA15-3、TSGF、OPN和CA125血清学联合检测是乳腺癌早期诊断和监控复发转移的较好指标，有利于临床早期发现、早期干预。

Combined detection of CA15-3,TSGF,OPN and CA125 in the diagnosis and treatment of breast cancer

Objective To explore the clinical value of combined detection of CA15-3, TSGF, OPN and CA125 in the diagnosis and treatment of breast cancer. Methods The serum specimens from 187 patients with breast cancer (cancer group) were collected, tumor markers CA15-3 and CA125 were detected with electrochemiluminescence method, TSGF was detected with chemocolorimetry, and OPN was detected with enzyme-linked immunosorbent assay. Compared with 50 cases of patients with benign breast disease (control group), The relationship between these marker and clinical stage, recurrence and metastasis of breast cancer were analyzed. Results The serum levels of CA15-3, CA125, TSGF and OPN in cancer group were significantly higher than those in control group (P ＜0.05). Four markers in high clinical stage(Ⅲ and Ⅳ stage)[(83.21±28.67), (89.13±32.34), (278.66±137.23) U/ml and (97.4±11.7) ng/ml, respectively] were higher than those in low stage( Ⅰ and Ⅱ stage) [(60.03±19.35), (58.21±17.56), (155.79±113.11) U/ml and (77.5±10.81) ng/ml,respectively] (P ＜0.05), and those in lymphnode metastasis patients and in recurrence patients were significantly higher than those in corresponding groups (P ＜0.05). The sensitivity and specificity of the combined detection of four tumor markers were 96.3 % (180/187) and 80.0 % (40/50), respectively. The average time of combined detection of serum tumor markers was 2 months ahead of the mammographic features in the recurrence patients with breast cancer. Conclusion The dynamic combined detection of CA15-3, TSGF, OPN and CA125 are better markers for monitoring recurrence and metastasis of breast cancer,which are benefit to early diagnosis and interference.