血清CAl5-3、CEA检测联合全身骨显像在乳腺癌骨转移中的诊断价值  

The value of combined examination of serum CA15-3, CEA level and whole body bone scan in the diagnosis of bone metastasis in breast cancer

作　　者：路宝士[1] 高玉芳[1] 

机构地区：[1]临沂市人民医院核医学科,山东省276003

出　　处：《国际放射医学核医学杂志》2011年第2期107-110,共4页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的评价血清肿瘤标志物糖类抗原15-3（CAI5-3）、癌胚抗原（CEA）检测联合全身骨显像在乳腺癌骨转移诊断中的价值。方法对97例乳腺癌患者（其中，骨转移组46例、无骨转移组51例）及45例良性乳腺疾病患者（良性病变组）行SPECT全身骨显像，对骨显像阴性但骨痛明显患者，再行CT或MRI检查以确诊。同时，用电化学发光法测定其血清CAl5-3、CEA水平，并将两者的结果进行比较。结果骨转移组CAl5—3、CEA水平明显高于无骨转移组和良性病变组，两项指标诊断骨转移的阳性率分别为76．09％、80．43％；骨转移组全身骨显像44例为阳性（占95．65％），仅2例为阴性（占4．35％），该2例骨显像阴性患者再经CT或MRI确诊为骨转移；无骨转移组中的7例及良性病变组中的3例骨显像为阳性，均由手术或外伤引起。CAl5—3＋CEA＋全身骨显像三项联检比CA15—3＋CEA两项联检及各单项检查在诊断乳腺癌骨转移中的灵敏度、特异性和准确率均明显提高。，结论全身骨显像和CAl5—3、CEA联合检测有助于提高乳腺癌骨转移的检出率。Objective To explore the value of combined examination of serum tumormarkers carbohydrate antigen 15-3 （CA 15-3 ）, careinoembryonic antigen （CEA） and whole body bone scan in the diag nosis of bone metastasis in breast cancer. Methods Whole body bone scan and serum CA15-3 and CEA levels with a electrochemical luminescence assay were performed in 97 palients with breast cancer （46 cases with bone metastasis and 51 cases without bone metastasis） and 45 patients with benign breast diseases. As for the negative cases who had significant pains in bones, CT or MRI was performed to make sure. Results The serum level of CA15-3 and CEA were significantly higher in patients with bone metastasis than those in patients without bone metastasis and the benign lesions. The positive predicting values were 76.09% and 80.43%. Most patients with bone metastasis had positive results in bone scan （95.65%）, only 2 cases had negative results （4.35%）, which is positive by CT or MRI Seven. Seven patients without bone metastasis and Three patients with the benign lesions had positive results in bone scan, that may be caused by previous operation or injury. The combined determination of CA15-3, CEA and whole body bone scan had a better performance in sensitivity, specificity and accuracy than each single way. Conclusion The combined determinationof CA15-3, CEA and whole body bone scan were valuable in the diagnosis of bone metastasis in breast cancer.

关 键 词：乳腺肿瘤 肿瘤转移 癌胚抗原 CA-15-3抗原 全身成像 体层摄影术 发射型计算机 单光子 

分 类 号：R737.9[医药卫生—肿瘤]