彩色多普勒超声联合血清CA15-3、CYFRA21-1、miR-20b-5p在早期乳腺癌诊断中的应用  

Application of color Doppler ultrasound combined with serum CA15-3,CYFRA21-1 and miR-20b-5p in the diagnosis of early breast cancer

作　　者：吴强[1] 谭蜀川 向伦祥[1] 王梦远[2] 游希 WU Qiang;TAN Shuchuan;XIANG Lunxiang;WANG Mengyuan;YOU Xi(Department of Ultrasound,Chongqing Three Gorges Central Hospital,Chongqing,China,404000;Department of Breast surgery,Chongqing Three Gorges Central Hospital,Chongqing,China,404000)

机构地区：[1]重庆三峡中心医院超声科,重庆404000 [2]重庆三峡中心医院乳腺外科,重庆404000

出　　处：《分子诊断与治疗杂志》2020年第9期1217-1220,1225,共5页Journal of Molecular Diagnostics and Therapy

基　　金：重庆市万州区社会发展领域科技计划指导性项目(wzstc-z201705)。

摘　　要：目的评价彩色多普勒超声联合血清糖类抗原15-3(CA15-3)、C角蛋白19片段抗21-1(CYFRA21-1)及miR-20b-5p对早期乳腺癌的诊断价值。方法选取2017年1月至2019年12月本院收取的82例早期乳腺癌患者,为观察组,另按年龄分层抽样选取50例良性乳腺病变患者为对照组,比较观察组与对照组彩色多普勒超声影像特征、血清CA15-3、CYFRA21-1及miR-20b-5p表达水平,以病理结果为金标准,评价各检查方式及联合检查诊断早期乳腺癌的诊断效能。结果观察组彩色多普勒超声中,肿块形状不规则、边缘不清、毛刺征、血流分级Ⅱ级和Ⅲ级、后方回声衰减、有微小钙化灶、纵横比≥1比例均显著高于对照组,差异有统计学意义(P<0.05);观察组血清CA15-3、CYFRA21-1、miR-20b-5p表达水平均显著高于对照组(P<0.05);以病理诊断结果为金标准,彩色多普勒超声、血清CA15-3+CYFRA21-1、miR-20b-5p及三者联合诊断早期乳腺癌的灵敏度、特异度、准确度、Kappa值分别为(0.720、0.820、0.758、0.512)、(0.878、0.860、0.871、0.730)、(0.829、0.920、0.879、0.750)、(0.988、0.800、0.917、0.816)。结论彩色多普勒超声联合血清CA15-3、CYFRA21-1、miR-20b-5p检测较单一检查能提高早期乳腺癌诊断灵敏度及准确度,具有临床应用价值。Objective To evaluate the diagnostic value of color Doppler ultrasound combined with serum carbohydrate antigen 15-3(CA15-3),C-keratin 19 fragment anti-21-1(CYFRA21-1)and miR-20 b-5 p in early breast cancer. Methods From January 2017 to December 2019,82 patients with early breast cancer were selected as the observation group,and another 50 patients with benign breast lesions were selected by age stratification as the control group. The color Doppler ultrasound imaging characteristics and the expression levels of serum CA15-3,CYFRA21-1 and miR-20 b-5 p were compared between the observation group and the control group,and the pathological results were used as the gold standard to evaluate the diagnostic efficacy of various examination methods and combined examinations in the diagnosis of early breast cancer. Results In the observation group of color Doppler ultrasound,the proportions of irregular mass shape,unclear edge,spicule sign,blood flow gradeⅡand gradeⅢ,posterior echo attenuation,microcalcification and aspect ratio≥1 were significantly higher than those in the control group,the difference was statistically significant(P<0.05). The expression levels of serum CA15-3,CYFRA21-1 and miR-20 b-5 p in the observation group were significantly higher than those in the control group(P<0.05). Taking pathological diagnosis results as the gold standard,the sensitivity,specificity,accuracy,and Kappa values of color Doppler ultrasound,serum CA15-3+CYFRA21-1,miR-20 b-5 p,and the three combined diagnosis of early breast cancer are(0.720,0.820,0.758,0.512),(0.878,0.860,0.871,0.730),(0.829,0.920,0.879,0.750),(0.988,0.800,0.917,0.816). Conclusion Color Doppler ultrasound combined with serum CA15-3,CYFRA21-1,miR-20 b-5 p detection can improve the sensitivity and accuracy of early breast cancer diagnosis compared with single examination,and has clinical application value.

关 键 词：早期乳腺癌 彩色多普勒超声 血清肿瘤标志物 循环MICRORNA 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]