人乳腺珠蛋白基因表达和趋化因子CXCL16及CA153在乳腺癌诊断中的应用

目的探讨人乳腺珠蛋白(HMAM)、趋化因子CXCL16及CA153在乳腺癌诊断和治疗监测中的应用。方法采用实时荧光定量PCR(FQ-PCR)检测50例女性体检者、134例良性乳腺肿瘤患者、129例乳腺癌患者和104例其他肿瘤患者外周血中HMAM mRNA,化学发光法检测CA153,ELISA检测CXCL16,分析三种标志物与乳腺癌患者临床组织学分期的关系、手术前后的差异及联合检测在乳腺癌诊断中的应用。结果乳腺癌组HMAM、CA153和CXCL16水平高于对照组和良性乳腺肿瘤组,HMAM和CA153水平高于其他肿瘤组(P<0.05)。乳腺癌组HMAM、CA153和CXCL16水平在手术后均下降,Ⅲ+Ⅳ期高于Ⅰ+Ⅱ期(P<0.05)。HMAM的检测特异性最强,CXCL16的检测灵敏度最高;CA153和CXCL16联合检测可提高灵敏度和阴性预测值;HMAM、CA153和CXCL16联合检测的特异性和阳性预测值高于CA153和CXCL16联合检测,HMAM、CA153和CXCL16联合检测的灵敏度、阳性预测值和阴性预测值高于单一指标检测(P<0.05)。结论HMAM和CA153对乳腺癌预后有一定的预测作用,HMAM、CA153、和CXCL16对术后随访有意义,联合检测有助于提高对乳腺癌诊断的早期诊断。

Clinical application of HMAM gene expression,CXCL16 and CA153 in the diagnosis of breast cancer

Objective To investigate the application of HMAM,CXCL16 and CA153 in the clinical diagnosis and therapy of breast cancer.Methods In 50 health women,129 patients with breast cancer,134 patients with benign breast disease and 104 patients with other malignant tumors,HMAM was detected by using FQ-PCR.CA153 was detected by chemical luminous method.CXCL16 was detected by ELISA.The relationships between the three tumor markers and histological grade as well as differences before and after surgery were analyzed.Combination of the three tumor markers for diagnose of breast cancer was also analyzed.Results The levels of HMAM,CXCL16 and CA153 in the breast cancer group were higher than those in the normal controls and the benign breast disease group.The levels of HMAM and CA153 in breast cancer group were higher than those in other malignant tumors group(P<0.05).The three indexes in the breast cancer group were decreased after operation when compared to before operation,and the indexes were higher in the stageⅢ+Ⅳthan those in the stageⅠ+Ⅱof breast cancer(P<0.05).The sensitivity of CXCL16 and the specificity of HMAM was the highest.The negative predictive value and the sensitivity were improved when combined detection of CA153 and CXCL16.The specificity and the positive predictive value of the combined three indexes were higher than the combined CA153 and CXCL16.The positive and negative predictive value and the specificity of the combined three indexes were higher than single one(P<0.05).Conclusion HMAM and CA153 play a role to predict the prognosis of breast cancer.Three indexes can be used to follow-up curative effect of breast cancer after operation.The combined detection of the three indexes is helpful to the diagnosis of breast cancer early.