肿瘤标志物在乳腺癌早期诊断和治疗中的应用  

The value of combined detection of biomarkers in the early diagnosis and treatment of breast cancer

作　　者：王刚平[1] 梁云爱[1] 郭小艳[1] 赵一诺[1] 徐风亮[2] 王洪远 

机构地区：[1]276826山东省,济宁医学院附属日照市人民医院,病理科 [2]276826山东省,济宁医学院附属日照市人民医院,检验科 [3]日照市中医院病理科

出　　处：《中国临床实用医学》2014年第1期-,共3页China Clinical Practical Medicine

基　　金：日照市应用技术研究与开发计划项目，济宁医学院科研计划重点项目

摘　　要：目的 探讨乳头溢液及血清肿瘤标志物动态联合检测在乳腺癌早期诊断和治疗中的价值.方法 选择2002年1月至2012年12月日照市人民医院收治的乳头溢液患者179例,其中,乳腺癌43例,良性病变136例,对所有患者的乳头溢液和血清CA153、TSGF、CA125及CEA水平进行检测,另选30例妊娠妇女乳头溢液作为健康对照组,分析与临床病理因素的关系.结果 乳腺癌组溢液及血清CA153、TSGF、CA125及CEA水平显著高于良性组和健康组(均P＜0.01);肿瘤标志物水平高与血性溢液、单孔溢液及ER/PR阴性、Ki-67增殖指数≥15％、组织学高分级(Ⅲ)、淋巴结转移及肿瘤复发等因素有关(P＜0.05),与患者年龄、肿瘤大小无关(P＞0.05).溢液和血清联合检测可使敏感性提高到97.67％,阴性预测值达99.03％,较单项及其他组合明显提高(P＜0.05).结论 溢液和血清CA153、TSGF、CA125及CEA联合检测可提高诊断阳性率和阴性预测值,可用于乳腺癌的早期诊断和监控转移复发.Objective To explore the value of combined detection of CA153,TSGF,CA125 and CEA both in nipple discharge and serum in the early diagnosis and treatment of breast cancer.Methods The serum and nipple discharge from 43cases of breast cancer and 136 cases of benign tumour was collected and tumor markers of CA153,TSGF,CA125 and CEA were detected.Results The nipple discharge and serum levels of CA153,TSGF,CA125 and CEA in bresat cancer patients were significantly higher than those in benign disease and normal women(P＜0.01).The levels of the four tumor markes had a positive correlation with Ki-67,gread,lymph node metastas and tumor recurrence (P＜0.05),and negative correlation with the level of ER and PR (P＜0.05).The sensitivity of the four markes in combination was 97.67％ and specificity was99.03％.Conclusion The dynamic combined detection of CA153,TSGF,CA125 and CEA both in nipple discharge and serum are benefit to early diagnosis and interference and better prewarning markers for monitoring their recurrence and metastasis of breast cancer.

关 键 词：乳腺癌 乳头溢液 肿瘤标志物 诊断 鉴别诊断 

分 类 号：R737[医药卫生—肿瘤]