患者血清前列腺特异抗原、细胞角蛋白19片段抗原21-1联合检测乳腺癌的临床研究  

The clinical study of combined detection of serum prostate specific antigen and cytokeratin 19 fragment antigen 21-1 in pathological stages of breast cancer

作　　者：李林[1] 熊有毅 秦威[1] 朱明智[1] 王楠[1] 王芳[1] 郭广成[1] 段馨[1] 陈卓[1] 谷元廷[1] 李建华[2] 

机构地区：[1]郑州大学第一附属医院乳腺外科,450052 [2]郑州大学第一附属医院甲状腺外科,450052

出　　处：《中华实验外科杂志》2017年第8期1388-1390,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨血清中前列腺特异抗原（PSA）、细胞角蛋白19片段抗原21-1（CYFRA21-1）联合检测对乳腺癌的诊断及病理分期的临床价值.方法 随机选择我院收治的200例乳腺癌患者为观察组;选择同时期我院确诊的200例乳腺良性疾病患者为对照组.检测患者血清中PSA、CYFRA21-1 水平,根据检测结果对乳腺癌早期诊断治疗过程中病情监测的临床价值.结果 观察组血清中游离PSA（fPSA）（0.19±0.04）ng/ml、总PSA（tPSA）（22.45±3.16）pg/ml,明显低于对照组的fPSA（0.35±0.08）ng/ml、tPSA（31.48±4.31）pg/ml;其CYFRA21-1（5.34±1.13）ng/ml明显高于对照组（3.67±1.07）ng/ml,差异有统计学意义（t=1.267,P=0.031;t=4.891,P=0.028;t=2.534,P=0.026）.观察组血清中fPSA、tPSA及CYFRA21-1及3项联合检测的阳性率明显高于对照组,差异有统计学意义（χ2=3.287,P=0.012;χ2=2.936,P=0.028;χ2=13.587,P=0.000;χ2=11.279,P=0.000）.观察组为病理证实的200例乳腺癌,其中Ⅰ-Ⅱ期73例,Ⅲ期76例,Ⅳ期51例.Ⅳ期乳腺癌患者血清中fPSA、tPSA含量明显低于Ⅰ-Ⅱ、Ⅲ期乳腺癌患者,CYFRA21-1含量明显高于Ⅰ-Ⅱ、Ⅲ期患者.Ⅲ期乳腺癌患者血清中tPSA、fPSA含量明显低于Ⅰ-Ⅱ期患者,血清中CYFRA21-1含量明显多于Ⅰ-Ⅱ期乳腺癌患者,差异有统计学意义（Ⅳ期与Ⅲ期依次比较,t=0.783,P=0.019;t=1.524,P=0.021;t=2.875,P=0.014）.tPSA±fPSA±CYFRA21-1联合检测能提高能使患者检测的敏感度提高到91.7%,特异性提高到92.8%,诊断的准确性提高到94.8%,均明显高于单项检测,差异有统计学意义（联合检测与单项CYFRA21-1比较,χ2=2.357,P=0.019;χ2=4.398,P=0.038;χ2=3.176,P=0.029）.结论 PSA联合CYFRA21-1检测可有效提高乳腺癌早期诊断率.Objective To observe the clinical efficacy of combined detection of serum prostate specific antigen （PSA） and CYFRA21-1 in breast cancer patients with pathological staging.Methods 200 cases of breast cancer patients were randomly selected from January 2015 to January 2016 in our hospital as the observation group;at the same time 200 cases of benign breast disease patients were selected as the control group.The serum levels of PSA and CYFRA21-1 were detected,and the clinical value of monitoring the disease during the early diagnosis and treatment of breast cancer was analyzed according to the test results.Results By comparison,the observation group free PSA （fPSA） in serum （0.19±0.04） ng/ml,total PSA （tPSA） （22.45±3.16） pg/ml was significantly lower than the control group fPSA （0.35±0.08） ng/ml,tPSA （31.48±4.31） pg/ml;CYFRA21-1 （5.34±1.13） ng/ml was significantly higher than the control group （3.67±1.07） ng/ml （t=1.267,P=0.031;t=4.891,P=0.028;t=2.534,P=0.026）.The positive rate of serum fPSA,tPSA,CYFRA21-1 and 3 joint tests in observation group was higher than that in control group （χ2=3.287,P=0.012;χ2=2.936,P=0.028;χ2=13.587,P=0.000;χ2=11.279,P=0.000）.There were 200 cases of breast cancer in the observation group confirmed by pathology,of which stage Ⅰ-Ⅱ 73 cases,stage Ⅲ 76 cases,and stage Ⅳ 51 cases.The serum levels of fPSA and tPSA in patients with stage Ⅳ breast cancer were significantly lower than those of Ⅰ-Ⅱ and Ⅲ breast cancer patients,and the content of CYFRA21-1 was significantly higher than that in patients with stage Ⅰ-Ⅱ and Ⅲ.The serum levels of tPSA and fPSA in patients with stage Ⅲ breast cancer were significantly lower than those in stage Ⅰ-Ⅱ,and the serum CYFRA21-1 content was significantly higher than that in stage Ⅰ-Ⅱ breast cancer patients （stage Ⅳ compared with stage Ⅲ,t=0.783,P=0.019;t=1.524,P=0.021;t=2.875,P=0.014）.The combined detection of tPSA＋fPSA＋CYFRA21-1 could increase the sensitivity of pa

关 键 词：联合检测 乳腺癌 病理分期 前列腺特异抗原 细胞角蛋白19片段抗原21-1 

分 类 号：R737.9[医药卫生—肿瘤]