可溶性E-钙黏连蛋白对良恶性乳房肿块的鉴别诊断价值

目的 分析良恶性乳房肿块患者可溶性E-钙黏连蛋白(sEC)水平,以期为乳腺癌的临床诊疗提供参考.方法 选择2017年3月至2020年9月在滁州市第一人民医院接受诊疗的120例患有乳房肿块的女性患者作为研究对象,回顾性分析患者的临床资料.将病理确诊为乳腺癌的62例患者作为观察组,确诊为良性乳房肿块的58例患者作为对照组.检测比较两组患者外周血sEC、糖类抗原125(CA125)、糖类抗原15-3(CA15-3)水平,并分析各项指标对良恶性乳房肿块的诊断价值.结果 观察组患者外周血中sEC水平为(2568.77±325.63)ng/mL、CA125为(39.35±7.51)U/mL、CA15-3为(44.97±7.40)U/mL,均高于对照组,差异有统计学意义(P<0.05).ROC曲线分析显示,sEC、CA125和CA15-3对应诊断的最佳截断值分别为2154.50 ng/mL、41.50 U/mL和37.50 U/mL,曲线下面积分别为0.850(95％CI:0.785～0.915)、0.756(95％CI:0.668～0.844)和0.858(95％CI:0.793～0.922),灵敏度分别为96.8％、51.6％和87.1％,特异度分别为55.2％、96.6％和67.2％,正确率分别为76.7％、73.3％和77.5％.淋巴结转移者的sEC水平高于无淋巴结转移者,差异有统计学意义(P<0.05).结论 sEC水平在乳腺癌患者中升高,对乳腺癌的早期诊断具有一定价值.

Value of soluble E-cadherin in differential diagnosis of benign and malignant breast lumps

Objective To analyze the level of soluble E-cadherin (sEC) in patients with benign and malignant breast masses in order to provide references for the clinical diagnosis and treatment of breast cancer. Methods A total of 120 female patients with breast lumps who were diagnosed and treated at the First People''s Hospital of Chuzhou City from March 2017 to September 2020 were selected as the research objects, and the clinical data of the patients were retrospectively analyzed. The 62 patients diagnosed with breast cancer pathologically were taken as the observation group, and 58 patients with benign breast masses were taken as the control group. The levels of sEC, carbohydrate antigen 125 (CA125) and carbohydrate antigen 15-3 (CA15-3) in the peripheral blood of the two groups of patients were tested and compared, and the diagnostic value of various indicators for benign and malignant breast masses was analyzed. Results The level of sEC in the peripheral blood of the observation group was (2 568.77±325.63) ng/mL, CA125 was (39.35±7.51) U/mL, and CA15-3 was (44.97±7.40) U/mL, which were higher than those of the control group, and the difference was statistically significant (P<0.05). ROC curve analysis showed that the best cut-off points for diagnosis of sEC, CA125 and CA15-3 were 2 154.50 ng/mL, 41.50 U/mL and 37.50 U/mL, respectively, and the area under the curve was 0.850 (95%CI:0.785~0.915), 0.756 (95%CI:0.668~0.844) and 0.858 (95%CI:0.793~0.922). The sensitivity was 96.8%, 51.6% and 87.1%, the specificity was 55.2%, 96.6% and 67.2%, and the correct rates was 76.7%, 73.3% and 77.5%, respectively. The sEC level of patients with lymph node metastasis was higher than those without lymph node metastasis, and the difference was statistically significant (P<0.05). Conclusion The level of sEC is elevated in breast cancer patients, which has certain value for the early diagnosis of breast cancer.