糖类抗原153、人附睾分泌蛋白4联合高频超声及钼靶在乳腺癌早期诊断中的应用研究  

Application of carbohydrate antigen 153,human epididymis protein 4 combined with high frequency ultrasound and mammography in the diagnosis of early breast cancer

作　　者：汪瑞[1] 周军[1] Wang Rui;Zhou Jun(Department of Thyroid and Breast Surgery,The First People’s Hospital of Lianyungang,Lianyungang 222000,China)

机构地区：[1]江苏省连云港市第一人民医院甲乳外科,云港222000

出　　处：《广西医科大学学报》2020年第8期1531-1536,共6页Journal of Guangxi Medical University

基　　金：连云港市卫生科技资助项目(No:局1405);江苏省卫生和计划生育委员会资助项目(No:F201433)。

摘　　要：目的:探讨糖类抗原153(CA153)、人附睾分泌蛋白4(HE4)、高频超声、钼靶在乳腺癌早期诊断中的应用价值。方法:选择2016年1月至2019年3月江苏省连云港市第一人民医院收诊的182例疑似乳腺癌早期患者,对所有患者进行病理活检、X线钼靶、高频超声以及血清CA153和HE4检查,分析早期乳腺癌的影像学特征,对比高频超声、钼靶、血清CA153和HE4水平及联合检查对乳腺癌早期诊断的灵敏度和特异性和成本效益比值。结果:共182例疑似者纳入研究,经病理活检共确诊早期乳腺癌136例,检出率为74.73%;实验组血清CA153和HE4表达水平明显高于对照组(P<0.05);血清CA153、HE4水平诊断早期乳腺的灵敏度、特异性、符合度都低于影像学手段;单一种检查手段诊断早期乳腺的灵敏度、特异性、符合度以及成本效益比都低于联合检查,且4种方法联合检查灵敏度、特异性、符合度以及成本效益比都最高。结论:钼靶和高频超声在乳腺癌早诊中有一定的临床应用优势。X线钼靶、高频超声、血清CA153和HE4联合检查用于诊断早期乳腺癌,可提高诊断准确性和诊断成本,值得临床推广运用。Objective:To explore the value of carbohydrate antigen 153(CA153),human epididymis protein 4(HE4),high frequency ultrasound and mammography in the diagnosis of early breast cancer.Methods:A total of 264 patients with suspected early breast cancer admitted to the First People’s Hospital of Lianyungang from January 2016 to March 2019 were selected as research subjects.Pathological examination of biopsy specimens,X-ray mammography,high-frequency ultrasound and serum CA153 and HE4 tests were performed on all patients.The imaging characteristics of early breast cancer was analyzed,and high-frequency ultrasound,mammography,serum CA153 and HE4 tests and the combination examination were compared in terms of the sensitivity,specificity and cost-benefit ratio in the diagnosis of early breast cancer.Results:A total of 182 suspects were included in the study,among whom 136 cases of early breast cancer were diagnosed by pathological examination of biopsy specimens,with a detection rate of 74.73%.The expression levels of serum CA153 and HE4 in the experimental group were significantly higher than those in the control group(P<0.05);the sensitivity,specificity,and conformity of the CA153 and HE4 tests in the diagnosis of early breast were lower than imaging methods;the sensitivity,specificity,conformity and cost-benefit ratio of any single examination method in the diagnosis of early breast were lower than the combination examination,and the examination that combines the four methods had the best sensitivity,specificity,compliance,and cost-benefit ratio.Conclusion:Mammography and high-frequency ultrasound have certain advantages in diagnosis of early breast cancer.The examination that combines Xray mammography,high-frequency ultrasound and serum CA153 and HE4 tests can improve accuracy and reduce cost in the diagnosis of early breast cancer,and it is worthy of wider clinical application.

关 键 词：乳腺癌 钼靶 高频超声 CA153 HE4 

分 类 号：R737.9[医药卫生—肿瘤]