基于乳头溢液标志物的乳腺良恶性疾病鉴别诊断模型的建立及价值评估  

evaluation of differential diagnosis model of benign and malignant breast diseases based on markers in nipple discharge

作　　者：梁永媛[1] 孙薏丰 张守彩 郑桂喜[1] LIANG Yong-yuan;SUN Yi-feng;ZHANG Shou-cai(Department of Clinical Laboratory,Qilu Hospital of Shandong University,Shandong Jinan 250012)

机构地区：[1]山东大学齐鲁医院检验科,山东济南250012

出　　处：《医学检验与临床》2021年第7期9-13,共5页Medical Laboratory Science and Clinics

摘　　要：目的:检测CA125,CA153,CA199,CA724和CEA在乳腺癌和乳腺良性疾病患者乳头溢液中的表达,探讨其在乳腺良恶性疾病中的鉴别诊断价值。方法:回顾性分析73例乳腺癌和189例乳腺良性疾病患者的乳头溢液中CA125,CA153,CA199,CA724和CEA的表达,上述标志物的检测均采用采用罗氏电化学发光方法。t检验统计分析上述标志物在乳腺癌组和良性疾病组的表达差异;ROC曲线评价CEA和CA153的鉴别诊断价值,并结合患者年龄、CEA和CA153建立鉴别诊断模型;采用Pearson8t检验分析CEA和CA153在乳头溢液和血清中的相关性。结果:乳腺癌组乳头溢液中CEA(1430.09±259.29)和CA153(4058.82±119.4)的表达显著高于乳腺良性疾病组(141.33±296.34,1402.28±306.04)(P<0.001,P<0.01),但CA125,CA724,CA199在乳腺癌患者组与良性乳腺疾病组之间无显著性差异(P=0.28,0.84,0.58);CEA和CA153对乳腺良恶性疾病鉴别诊断的最佳Cut-off值分别为230.88ng/ml和639.68U/ml。CEA的曲线下面积为0.828,显著优于CA153(0.709,P=0.0004)。将年龄、CEA和CA153联合应用建立鉴别诊断模型,得到公式:-4.525+0.060*年龄+0.056*CEA+0.002*CA153,以0.73为Cut-off值,其敏感性和特异性分别为100%和95.2%;CEA在乳头溢液和血清中的表达呈正相关(r=0.9690,P<0.0001),而CA153在乳头溢液和血清中的表达无相关性(r=0.01577,P=0.95)。结论:乳头溢液CEA和CA153是较好的乳腺良恶性疾病鉴别诊断标志物,与年龄联合建立鉴别诊断模型具有更优的价值。Objective:To detect the expression of CA125,CA153,CA199,CA724 and CEA in nipple discharge of breast cancer and benign breast diseases.To predict the values of tumor markers in nipple discharge in differential diagnosis of breast cancer and benign breast diseases.Methods:The expression level of CA125,CA153,CA199,CA724 and CEA in nipple discharge of 73 cases of breast cancer and 189 cases of benign breast disease were analyzed retrospectively which were detected by electrochemical luminescence method of Automatic Electrochemical Luminescence Instrument made by Roche.The differential expression of these markers was analyzed by t-test between breast cancer group and benign breast disease group.ROC curve was used to evaluate the differential diagnostic value of CEA and CA153.Then a differential diagnostic model was established based on patients'age,CEA and CA153.Pearson t test was used to analyze the correlation of CEA and CA153 between nipple discharge and serum.Results:The expression of CEA(1430.09±259.29)and CA153(4058.82±119.4)in nipple discharge of breast cancer group was significantly higher than that of benign breast disease group(141.33±296.34,1402.28±306.04)(P<0.001,P<0.01).There was no significant difference in CA125,CA724,CA199 between two groups(P=0.28,0.84,0.58).The optimal Cut-off values of CEA and CA153 for differential diagnosis of benign and malignant breast diseases were 230.8ng/ml and 639.6U/ml,respectively.The AUC of CEA was 0.828,which was significantly better than that of CA153 which was 0.709(P=0.0004).Age,CEA and CA153 were combined to establish the differential diagnosis model.The formula was as follows:-4.525+0.060*age+0.056*CEA+0.002*CA153.The sensitivity and specificity were 100%and 95.2%with 0.73 as the cut-off value.The expression of CEA was positively correlated in nipple discharge and serum(r=0.9690,P<0.0001),while there is no significant correlation of CA153 between nipple discharge and serum(r=0.01577,P=0.95).Conclusion:CEA and CA153 in nipple discharge were good markers for the d

关 键 词：乳腺癌 乳头溢液 鉴别诊断模型 癌胚抗原 糖类抗原153 

分 类 号：R73[医药卫生—肿瘤]