USCNB联合肿瘤标志物诊断乳腺癌、评估腋窝淋巴结分期中的价值  

Value of USCNB combined with tumor markers in the diagnosis of breast cancer and the evaluation of axillary lymph node staging

作　　者：张朝晖 苏锡雄 江亚 杨琴 马睿 金颖 ZHANG Zhaohui;SU Xixiong;JIANG Ya;YANG Qin;MA Rui;JIN Ying(Department of Ultrasonic Diagnosis,920th Hospital,Chinese People's Liberation Army Joint Logistic Support Force,Kunming 650000,China;Department of Pathology,920th Hospital,Chinese People's Liberation Army Joint Logistic Support Force,Kunming 650000,China;Department of Laboratory Medicine,920th Hospital,Chinese People's Liberation Army Joint Logistic Support Force,Kunming 650000,China)

机构地区：[1]中国人民解放军联勤保障部队第九二〇医院超声诊断科,云南昆明650000 [2]中国人民解放军联勤保障部队第九二〇医院病理科,云南昆明650000 [3]中国人民解放军联勤保障部队第九二〇医院检验科,云南昆明650000

出　　处：《医学影像学杂志》2024年第5期87-91,共5页Journal of Medical Imaging

基　　金：云南省卫生健康委员会医学中心课题计划项目(编号:ZX20191029)。

摘　　要：目的 探讨超声引导下空芯针穿刺活检(USCNB)联合肿瘤标志物诊断乳腺癌、评估腋窝淋巴结分期中的价值。方法 选取我院114例疑似乳腺癌患者,以病理诊断为金标准,评价USCNB、肿瘤标志物对乳腺癌的诊断价值,并对比不同腋窝淋巴结分期患者USCNB阳性率、肿瘤标志物水平及与腋窝淋巴结分期的相关性。结果 114例经手术病理检查确诊乳腺癌83例,腋窝淋巴结分期N0期17例、N1期30例、N2期20例、N3期16例;USCNB检查显示阳性82例,腋窝淋巴结分期N3、N2期患者USCNB阳性率>N1期患者>N0期患者,差异有统计学意义(P<0.05);乳腺癌患者血清癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)水平高于非乳腺癌患者,差异有统计学意义(P<0.05);腋窝淋巴结分期N3期患者血清CEA、CA125、CA153水平>N2期患者>N1期患者>N0期患者,差异有统计学意义(P<0.05);ROC曲线分析,USCNB、血清CEA、CA125、CA153联合诊断乳腺癌的AUC为0.936(95%CI:0.875~0.974);USCNB阳性率、血清CEA、CA125、CA153水平与腋窝淋巴结分期呈正相关(P<0.05)。结论 USCNB联合血清CEA、CA125、CA153在乳腺癌诊断中具有可靠的应用价值,还能为临床评估腋窝淋巴结分期提供数据支持。Objective To evaluate the value of ultrasound-guided hollow needle puncture biopsy(USCNB)combined with tumor markers in the diagnosis of breast cancer and the staging of axillary lymph nodes.Methods 114 suspected patients with breast cancer in our hospital were selected,and the diagnostic value of USCNB and tumor markers for breast cancer was evalu⁃ated with surgical and pathological diagnosis as the gold standard.The positive rate of USCNB,the level of tumor markers and the correlation between USCNB and axillary lymph node stage in patients with different axillary lymph node stage were com⁃pared.Results There were 83 cases of breast cancer confirmed by operation and pathological examination of those 114 pa⁃tients,including 17 cases of axillary lymph node stage N0,30 cases of N1,20 cases of N2 and 16 cases of N3.82 cases showed positive USCNB,and the positive rate of USCNB in axillary lymph node stage N3 and N2 was higher than that in N1 and N0(P<0.05).The serum levels of carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)and carbohydrate antigen 153(CA153)in breast cancer patients were higher than those in non-breast cancer patients(P<0.05).Serum CEA,CA125 and CA153 levels in patients with axillary lymph node stage N3 were higher than those in patients with stage N2,stage N1,and stage N0(P<0.05).ROC curve analysis showed that the AUC of USCNB,serum CEA,CA125 and CA153 combined in the diag⁃nosis of breast cancer was 0.936(95%CI:0.875-0.974).The positive rate of USCNB,serum CEA,CA125 and CA153 levels was positively correlated with axillary lymph node staging(P<0.05).Conclusions USCNB combined with serum CEA,CA125 and CA153 has a reliable application value in the diagnosis of breast cancer,and can also provide data support for clinical evalu⁃ation of axillary lymph node staging.

关 键 词：乳腺癌 腋窝淋巴结分期 超声引导下空芯针穿刺活检 肿瘤标志物 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]