肿瘤标志物联合检测在乳腺癌诊断中的价值  

Diagnostic value of combined multi-tumor markers for patients with breast cancer

作　　者：邵惠江[1] 高纯[2] 公艳蕾[2] 喻霞云[2] 林德华[2] 王玉林[2] 

机构地区：[1]苏州大学附属儿童医院检验科,江苏苏州215003 [2]苏州大学附属第一医院检验科,江苏苏州215006

出　　处：《中国现代医学杂志》2011年第30期3772-3776,共5页China Journal of Modern Medicine

摘　　要：目的探讨微阵列酶联免疫法(Array-ELISA)检测肿瘤标志物诊断乳腺癌的价值。方法采用Array-ELISA对146例乳腺癌患者、64例乳腺良性疾病患者及119例健康体检者的血清进行甲胎蛋白(AFP)、癌胚抗原(CEA)、癌抗原125(CA125)、癌抗原153(CA153)、糖链抗原199(CA199)、前列腺特异抗原(PSA)6种肿瘤标志物检测。应用Logistic回归和ROC曲线对各指标进行分析。结果乳腺癌组CA153、CA125均明显高于乳腺良性疾病组与正常对照组(P<0.05);其他四种肿瘤标志物(AFP、PSA、CA199、CEA)在3组间差异无统计学意义(P>0.05)。CA153、CA125两项联合检测,其敏感性为81.51%、准确度为86.93%、阴性预测值为86.08%,与单项指标比较差异均有统计学意义(P<0.05)。CA153、CA125两项肿瘤标志物单独检测时,CA153的AUC为0.874较CA125大;两项联合指标的AUC达0.913,大于各单项肿瘤标志物(P<0.05)。结论 CA153、CA125是乳腺癌的肿瘤相关性标志物,CA153对于乳腺癌的诊断价值更大。2项指标联合检测优于单一的肿瘤标志物,可提高诊断乳腺癌的正确性。Array-ELISA检测多种肿瘤标志物可应用于乳腺癌的诊断。[Objective]To investigate the application value of Array-ELISA in diagnosing breast cancer by detecting multi-tumor markers.[Methods]Using Array-ELISA to determine and analyze the concentration value of 6 tumor markers（AFP,CEA,CA199,CA125,CA153 and PSA） in sera of 146 breast cancer,64 patients with benign breast disease,and 119 normal individuals.The results were analyzed by logistic regression equation and ROC curve.[Results]The serum levels of CA153,CA125 in the patients with breast cancer were higher than those of normal individuals and patients with benign breast disease（P〈0.05）.The levels of the other four tumor markers were not significantly different among the three groups（P〈0.05）.The sensitivity,accuracy and negative predictive rate of combined two tumor markers of serum CA153 and CA125 were 81.51%,86.93%and 86.08%,which had prognostic significance compared with CA153 and CA125 alone（P〈0.05）.The AUC of CA153 was 0.874 and it was higher than that of CA125.The AUC of two combined tumor markers of CA153 and CA125 was 0.913 and it was higher than any AUC of CA153 or CA125 alone（P〈0.05）.[Conclusion]CA153 and CA125 were the correlative tumor markers of breast cancer,and CA153 was more helpful in diagnosing breast cancer.Detection of combining CA125 with CA153 was better than single tumor marker,which can raise the accuracy of diagnosing patients with breast cancer.Detecting multi-tumor markers with Array-ELISA technology can be applied to diagnose the breast cancer in clinic.

关 键 词：微阵列酶联免疫法 乳腺癌 肿瘤标志物 联合检测 

分 类 号：R737.304[医药卫生—肿瘤]