外周血红细胞分布宽度、血清同型半胱氨酸和糖类抗原15-3水平单独或联合诊断乳腺癌的价值  

Values of peripheral blood red blood cell distribution width,serum homocysteine and carbohydrate antigen 15-3 levels in diagnosis of breast cancer,alone or in combination

作　　者：张维 杨秋[1] 欧志红[1] 王红[1] ZHANG Wei;YANG Qiu;OU Zhi-hong;WANG Hong(Department of Clinical Laboratory,Guilin Hospital of Traditional Chinese Medicine,Guilin 541002,China)

机构地区：[1]广西桂林市中医医院检验科,桂林市541002

出　　处：《广西医学》2022年第4期389-393,共5页Guangxi Medical Journal

基　　金：广西壮族自治区卫生健康委员会科研课题(Z20200326)。

摘　　要：目的探讨外周血红细胞分布宽度(RDW)、血清同型半胱氨酸(Hcy)和糖类抗原15-3(CA15-3)水平单独及联合诊断乳腺癌的价值。方法纳入90例乳腺癌患者(乳腺癌组)、88例乳腺良性肿瘤患者(乳腺瘤组)、80例健康体检者(健康对照组)。比较3组外周血RDW、血清Hcy、血清CA15-3水平,并分析三者与乳腺疾病类型的相关性。采用受试者工作特征(ROC)曲线评估外周血RDW、血清Hcy、血清CA15-3水平单独及联合诊断乳腺癌的效能。结果乳腺癌组、乳腺瘤组和健康对照组的血清Hcy、外周血RDW和血清CA15-3水平依次降低(均P<0.05)。血清Hcy、外周血RDW和血清CA15-3水平与乳腺疾病类型均呈正相关(均P<0.05),即血清Hcy、外周血RDW和血清CA15-3水平越高,患者患乳腺癌的可能性越大。血清Hcy、外周血RDW和血清CA15-3单独诊断乳腺癌的曲线下面积(AUC)分别为0.746、0.762、0.797,三者差异均无统计学意义(均P>0.05);血清Hcy、外周血RDW和血清CA15-3联合诊断乳腺癌的AUC为0.867,大于任意一指标单独诊断时的AUC(均P<0.05)。结论乳腺癌患者外周血RDW、血清Hcy和血清CA15-3水平均较乳腺良性肿瘤患者和健康女性升高,三者在乳腺癌的诊断中都有一定的临床价值,联合检测能提高诊断效能。Objective To investigate the values of peripheral blood red blood cell distribution width(RDW),serum homocysteine(Hcy)and carbohydrate antigen 15-3(CA15-3)levels in the diagnosis of breast cancer,alone and in combination.Methods Ninety patients with breast cancer(breast cancer group),88 patients with benign breast tumors(breast tumor group)and 80 healthy individuals receiving physical examinations(healthy control group)were enrolled.The levels of peripheral blood RDW,serum Hcy,and serum CA15-3 were compared among the three groups.In addition,the correlations between the three indicators and the types of breast diseases were analyzed.The receiver operating characteristic(ROC)curve was employed to evaluate the efficiency of peripheral blood RDW,serum Hcy,and serum CA15-3 levels for diagnosing breast cancer,alone and in combination.Results The levels of serum Hcy,peripheral blood RDW,and serum CA15-3 decreased in the breast cancer group,breast tumor group and healthy control group successively(all P<0.05).The levels of serum Hcy,peripheral blood RDW,and serum CA15-3 positively correlated with the types of breast diseases(all P<0.05),i.e.the higher the level of serum Hcy,peripheral blood RDW,or serum CA15-3 was,the greater the possibility of breast cancer that the patients had.For diagnosing breast cancer,the areas under the curve(AUC)of serum Hcy,peripheral blood RDW,and serum CA15-3 were 0.746,0.762,and 0.797,respectively,showing no statistically significant difference among the three indicators(all P>0.05);for diagnosing breast cancer,the AUC of the combination of serum Hcy,peripheral blood RDW and serum CA15-3 was 0.867,which was greater than the AUC of a single indicator(all P<0.05).Conclusion The levels of peripheral blood RDW,serum Hcy,and serum CA15-3 are increased in patients with breast cancer than in patients with benign breast tumors or healthy females.All of these three indicators have certain clinical value in the diagnosis of breast cancer,and their combined detection can improve the diagnostic efficie

关 键 词：乳腺癌 糖类抗原15-3 同型半胱氨酸 红细胞分布宽度 辅助诊断 诊断效能 

分 类 号：R737.9[医药卫生—肿瘤]