应用ROC曲线分析评价肿瘤标志物糖类抗原15-3、癌胚抗原在乳腺癌诊断与术后监测中的价值  

Evaluation of the clinical value of CA15-3 and CEA in diagnosis and postoperative monitoring of breast cancer using ROC curves

作　　者：范海燕[1] 孟凡云[1] 章阳[2] 魏仲香[1] 关众[2] 

机构地区：[1]聊城职业技术学院,聊城252000 [2]聊城市人民医院乳腺甲状腺外科

出　　处：《中华乳腺病杂志（电子版）》2010年第6期32-35,共4页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：聊城职业技术学院2009年科研项目(2009LZY36)

摘　　要：目的评价肿瘤标志物糖类抗原15-3(carbohydrate antigen,CA15-3)、癌胚抗原(carcino-embryonic antigen,CEA)在乳腺癌诊断与术后复发转移判断中的应用价值。方法采用化学发光免疫分析法测定110例乳腺癌患者、50例乳腺良性疾病患者及40例正常对照者的血清CA15-3、CEA水平。组间比较采用χ2检验。用ROC曲线评价CA15-3、CEA在乳腺癌诊断和术后复发转移判断中的应用价值。结果 110例患者中CA15-3和CEA阳性检出率分别为32.7%(36/110)和12.7%(14/110)。I期、II期乳腺癌患者CA15-3、CEA血清含量无明显变化,与良性组和正常对照组相比差异无统计学意义(P>0.050)。以43例Ⅲ期、Ⅳ期乳腺癌患者的CA15-3、CEA测定值绘制ROC曲线,分析显示,CA15-3、CEA的ROC曲线下面积(AUC)分别为82.3%、81.1%,95%可信区间分别为0.719～0.929、0.714～0.906。术后复发转移患者CA15-3、CEA阳性检出率分别为85.7%(18/21)、52.4%(11/21),AUC分别为97.8%、89.1%,95%可信区间分别为0.944～1.011、0.790～0.991。结论通过ROC曲线评价可得出,CA15-3、CEA对Ⅲ期、Ⅳ期乳腺癌诊断有临床参考价值,在术后复发转移诊断中有较高的应用价值,可作为乳腺癌术后监测复发转移的有效指标。Objective To explore and evaluate the clinical value of tumor markers, carbohydrate antigen （CA）15-3 and careino-embryonic antigen （CEA） in diagnosis of breast cancer and postoperative monitoring of recurrence and metastasis. Methods The serum CA15 3 and CEA levels were measured by chemiluminescent immunoassay （CILA） technique in 110 breast cancer patients, 50 benign breast tumor patients and 40 healthy controls. Chi-square test was used for comparison between groups. ROC curve was used to evaluate the application value of CA153 and CEA as tumor markers in diagnosis and judgment of postoperative recurrence and metastasis for breast cancer. Results In the 110 breast cancer patients, the positive rates of CA15-3 and CEA were 32, 7% （36/110） and 12.7% （14/110）, respectively. There was no obvious change in the serum levels of CA15 3 and CEA in stage I and II breast caiacer paients, with no statistical difference compared with the benign group and the control group （P〉0. 050）. ROC curve analysis was done only in the 43 patients of stage III and IV breast cancer, which showed the area under the ROC curve （AUC） of CA15-3 and CEA was 82.3% and 81.1%, and the 95%CI was 0. 719%. 929 and 0. 714-0. 906, respectively. For postoperative recurrence and metastasis, the positive rates of CA15-3 and CEA were 85.7 % （18/21） and 52.4 % （11/21）, the AUC was 97. 8% and 89. 1%, the 95% CI was 0. 944 - 1. 011 and 0. 790 ~0. 991, respectively. Conclusions CA15-3 and CEA as tumor markers both have reference value in diagnosis of stage III and IV breast cancer patients and applicable value in diagnosis of postoperative recurrence and metastasis.

关 键 词：乳腺肿瘤 抗原 肿瘤相关 碳水化合物 癌胚抗原 诊断 ROC曲线 肿瘤标志物 

分 类 号：R737.9[医药卫生—肿瘤]