血清ICTP和TRACP 5b联合检测对乳癌骨转移的诊断价值  

Serum Tartrate-Resistant Acid Phosphatase 5b （TRACP 5b） and Carboxyterminal Cross-Linked Telopeptide of Type Ⅰ Collagen （ICTP） in the D!agnosis of Bone Metastasis of Breast Cancer

作　　者：裴雷[1] 唐中华[1] 

机构地区：[1]中南大学湘雅二医院乳甲外科,湖南长沙410011

出　　处：《医学临床研究》2016年第10期1899-1902,共4页Journal of Clinical Research

基　　金：湖南省自然科学基金（2015JJ3133）,国家自然科学基金青年基金（81502545）

摘　　要：[目的]探讨血清ICTP和TRACP5b水平及其联合检测用于诊断乳腺癌骨转移的临床意义。[方法]选取中南大学湘雅二医院乳甲专科2013年1月至2014年12月收治的714例乳腺癌患者，按是否有癌转移分为骨转移和无骨转移两组，通过酶联免疫吸附法检测血清ICTP和TRACP5b水平，应用受试者工作特征（ROC）曲线分析方法计算cut-off值，分别比较各血清学诊断方法的敏感性、特异性。[结果]骨转移组患者血清ICTP和TRACP5b均明显高于无骨转移组（P〈0．01）。血清ICTP和TRACP5b水平升高诊断骨转移的cut—off值分别为5．2btg／L和5．6U／L，灵敏度为81．1％和74．3％，特异度为89．4％和90．8％。两者均有较高的诊断效能。联合诊断的cut-off值为14．8，敏感度为93．2％，特异度为88．0％，较单独测定血清指标有显著的提高。[结论]血清ICTP和TRACP5b是乳腺癌骨转移的预测指标，联合检测对于诊断乳腺癌骨转移有重要意义。[Objective]To study the clinical significance of serum tartrate-resistant acid phosphatase 5b （TRACP 5b） and carboxyterminal cross-linked telopeptide of type Ⅰ collagen （ICTP） in diagnosing bone metastasis of breast cancer. [Methods]A total of 714 patients in the Breast and Thyroid Department of the Second Xiangya Hospital were included in this study and were divided into two groups based on the occurrence of bone metastasis. The bone metastasis group had 74 patients and the nonbone metastasis group had 640 patients. Serum ICTP and TRACP 5b were measured by using the ELISA method. The cut-off values were calculated using the receiver operating characteristic curve （ROC） method, and the sensitivity and specificity of each serological diagnostic method were compared. [Results]The levels of serum ICTP and TRACP 5b were higher in the bone metastasis group than in the non-bone metastasis group with statistical significance （ P 〈0.01）. The cut-off values of serum ICTP and TRACP 5b were 5.2μg/L and 5.6 U/L, respectively. Sensitivity was 81.1% and 74.3 %, and specificity was 89.4% and 90.8%, respectively. The sensitivity and specificity of the combined diagnosis was 93.2% and 88.0%, respectively, and was higher than the diagnosis using either solely ICTP or TRACP 5b. [Conclusion]Serum ICTP and TRACP 5b are important biomarkers for the diagnosis of bone metastasis in breast cancer. Combination of the two biomarkers provides very meaningful for the diagnosis.

关 键 词：胶原Ⅰ型/血液 吡啶类/诊断应用 肽类/诊断应用 酒石酸盐类 酸性磷酸酶 乳腺肿瘤/病理学 骨肿瘤/继发性 

分 类 号：R737.9[医药卫生—肿瘤]