HE4和 CA153联合表达在预测早期乳腺癌淋巴结转移中的意义

目的：探讨血清人附睾分泌蛋白4（HE4，human epididymis protein 4）和糖类抗原153（CA153，carbo-hydrate antigen 153）联合表达在预测早期乳腺癌淋巴结转移中的意义。方法：用酶联免疫（enzyme - linked im-munosorbent assay，ELISA）法检测100例 I - II 期乳腺癌患者血清中 HE4和 CA153水平，对不同淋巴结转移情况的 HE4和 CA153水平变化进行比较，并行 Logistic 回归分析，应用 ROC 曲线（receiver operating characteristic curve）分析 HE4和 CA153对淋巴结转移的预测价值。结果：早期乳腺癌有淋巴结转移组 HE4和 CA153水平高于无淋巴结转移组，差异有统计学意义（P <0.000），经 Logistic 回归分析，肿瘤大小、浸润深度和 CA153水平是影响早期乳腺癌淋巴结转移的独立危险因素。HE4的 AUC 为0.792，P =0.000，95% CI：0.622～0.862。CA153的 AUC 为0.885，P =0.000，95% CI：0.612～0.859。当 HE4的截断值为105.4pg/ L、CA153的截断值为40.4U/ L 时，其乳腺癌淋巴结转移的预测价值最佳。结论：HE4和 CA153联合表达时其水平变化在预测早期乳腺癌淋巴结转移中有重要参考价值。

Significance of combining expression of serum HE4 and CA153 in predicting lymph node metastasis of early stage breast cancer

Objective:To Significance of combining expression of serum HE4(human epididymis protein 4)and CA153(carbohydrate antigen 153)in predicting lymph node metastasis of early stage breast cancer. Methods:Serum HE4 and CA153 level were detected with enzyme - linked immunosorbent(ELISA)in 100 cases of stage I - II with breast cancer surgery,the HE4 and CA153 level changes of different lymph node metastasis were compared and Logis-tic Regression analysis,Using ROC curve(receiver operating characteristic curve)analysis of HE4 and CA153 pre-dictive value of lymph node metastasis. Results:Early breast cancer with lymph node metastasis group of HE4 and CA153 levels higher than without lymph node metastasis group,the difference was statistically significant(P <0. 000),Logistic regression analysis after the show,the tumor size,depth of invasion and CA153 level is an independ-ent risk factor of early breast cancer lymph node metastasis. Application of ROC curve( receiver operating character-istic curve)was analyzed,the area under the HE4 curve AUC(area under curve)was 0. 792,P = 0. 000,95%CI:0. 622 ~ 0. 862,CA153 curve AUC(area under curve)was 0. 885,P = 0. 000,95% CI:0. 612 ~ 0. 859,the best predictive value of lymph node metastasis of breast cancer. When the cutoff value of HE4 is 105. 4pg/ L,CA153 cutoff value is 40. 4U/ L. Conclusion:Combining expression of serum HE4 and CA153,the level of change had important reference value in predicting lymph node metastasis of early stage breast cancer.