MRI联合血清CA153、CEA、CYFRA21-1水平检测对乳腺癌患者诊断效能的影响  

Effect of MRI combined with serum levels of CA153,CEA and CYFRA21-1 on the diagnostic efficacy of breast cancer patients

作　　者：李晓会[1] 孙泓泓[1] 张秋娟[1] 周小倩[1] 唐亚萍[2] 吴红梅[1] Li Xiaohui, Sun Honghong, Zhang Qiujuan, Zhou Xiaoqian, Tang Yaping, Wu Hongmei(Department of Medical Imaging, Second Affiliated Hospital of Xi＇an Jiao Tong University, Xi＇ an 710004, China ; Department of Ceneral Surgery, Second Affiliated Hospital of Xi＇an Jiao Tong University, Xi＇an 710004, China)

机构地区：[1]西安交通大学第二附属医院医学影像科,710004 [2]西安交通大学第二附属医院医学普外科,710004

出　　处：《中国医师杂志》2018年第9期1338-1341,1347,共5页Journal of Chinese Physician

摘　　要：目的分析磁共振成像(MRI)联合血清糖类抗原153(CA153)、癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)水平检测对乳腺癌患者诊断效能的影响。方法选取2015年12月至2017年12月本院收治的80例乳腺癌患者为观察组,另选取98例良性乳腺疾病患者为对照A组,同期94例健康体检女性为对照B组。以电化学发光分析法测定比较3组血清CA153、CEA、CYFRA21-1水平,比较观察组不同分期患者(Ⅰ～Ⅱ期、Ⅲ～Ⅳ期)上述血清指标水平,并对3组采取MRI检查,分析MRI与血清CA153、CEA、CYFRA21-1联合及单独诊断乳腺癌的特异度、灵敏度及准确度。结果 3组血清CA153、CEA、CYFRA21-1水平比较,差异有统计学意义(P<0.05),且观察组血清CA153、CEA、CYFRA21-1水平高于对照A组与对照B组(P <0.05);观察组Ⅲ～Ⅳ期患者血清CA153、CEA、CYFRA21-1水平高于Ⅰ～Ⅱ期患者(P<0.05);采用MRI与血清CA153、CEA、CYFRA21-1联合诊断乳腺癌的灵敏度、准确度分别为96.25%(77/80)、84.93%(231/272),均高于应用血清CA153、CEA、CYFRA21-1单独诊断(P <0.05);且联合诊断的灵敏度高于MRI单独诊断(P<0.05)。结论应用MRI联合血清CA153、CEA、CYFRA21-1水平检测能显著提升乳腺癌诊断灵敏度与准确度,降低漏诊风险,为乳腺癌诊治提供有力依据。Objective To investigate the effect of color magnetic resonance imaging （MRI） combined with serum levels of carbohydrate antigen 153 （CA153）, carcinoembryonic antigen （CEA） and cytokeratin 19 fragment antigen 21-1 （CYFRA21-1） on the diagnostic efficacy of breast cancer patients. Methods From December 2015 to December 2017,80 cases of breast cancer in our hospital were selected as the observation group. Another 98 patients with benign breast diseases as control group A, and 94 healthy women as control group B. The serum levels of CA153, CEA and CYFRA21-1in the three groups were measured by electrochemiluminescence and the level of the above serum indexes in patients with different disease stages （stage Ⅰ、Ⅱ ,Ⅲ to Ⅳ ） in the observation group were compared. The 3 groups were examined by color Doppler high frequency ultrasound. The specificity, sensitivity and accuracy of color Doppler ultrasound combined with serum CA153, CEA and CYFRA21-1 or detecting alone in the diagnosis of breast cancer analyzed. Results There were significant differences in the levels of serum CA153, CEA and CYFRA21-1 in the 3 groups （P 〈0.05） , and the level of serum CA153, CEA and CYFRA21-1 in the observation group was higher than that in the control group A and the control group B （ P 〈 0. 05 ）. The levels of serum CA153, CEA and CYFRA21-1 in patients in stage Ⅲ to Ⅳ of the observation group were higher than those in patients in stage ⅠtoⅡ （P 〈 0. 05）. The sensitivity and accuracy of color Doppler ultrasound combined with serum CA153, CEA and CYFRA21-1 in the diagnosis of breast cancer were 96. 25% （77/80） and 84. 93% （231/272）, respectively, which were all higher than those of serum CA153, CEA and CYFRA21-1 alone （P 〈 0.05 ）. And the sensitivity of combined diagnosis was higher than that of color Doppler high frequency ultrasound alone （P 〈 0. 05）. Conclusions Color Doppler ultrasound combined with serum levels of CA153, CEA and CYFRA21-1 can significantly improve

关 键 词：乳腺肿瘤/诊断 磁共振成像 CA-15-3抗原/血液 癌胚抗原/血液 角蛋白19/血液 抗原 肿瘤 

分 类 号：R737.9[医药卫生—肿瘤]