乳腺钼靶联合血清ALP、ANXA2表达水平对乳腺浸润性导管癌的早期诊断价值  

Early diagnostic value of breast molybdenum target combined with serum ALP and ANXA2 expression levels for invasive ductal carcinoma of the breast

作　　者：汪琴 周排军 包静 吴磊 贺兰 熊敏超[1] WANG Qin;ZHOU Pai-jun;BAO Jing(Department of Medical Imaging,Ezhou Central Hospital,Ezhou Hubei 436000,China)

机构地区：[1]鄂州市中心医院医学影像科,湖北鄂州436000

出　　处：《临床和实验医学杂志》2024年第15期1659-1663,共5页Journal of Clinical and Experimental Medicine

基　　金：湖北省卫生健康委科研项目资助(WJ2021M312)。

摘　　要：目的探讨乳腺钼靶联合血清碱性磷酸酶(ALP)、膜联蛋白A2(ANXA2)表达水平对乳腺浸润性导管癌(IDC)的早期诊断价值。方法前瞻性选取2020年6月至2023年9月鄂州市中心医院收治的IDC患者380例为IDC组,选取同期本院收治的乳腺良性疾病患者256例为良性病变组,另选取同期来我院体检的健康女性215名为对照组。收集比较IDC组及良性病变组患者临床资料、乳腺钼靶特征;比较对照组、良性病变组、IDC组血清ALP、ANXA2、癌胚抗原(CEA)和糖类抗原(CA)153水平;采用多因素Logistic回归模型分析IDC发生的影响因素;采用受试者操作特征(ROC)曲线评估乳腺钼靶联合血清ALP、ANXA2水平诊断IDC的价值。结果IDC组患者肿块边缘模糊、边缘伴毛刺、泥沙样钙化、形态不规则、乳腺结构紊乱的比例分别为35.53%、24.21%、16.05%、23.16%、33.42%,均显著高于良性病变组(13.28%、8.98%、3.91%、7.42%、4.69%),差异均有统计学意义(P<0.05)。IDC组血清ALP、ANXA2、CEA及CA153水平分别为(91.63±12.39)U/L、(36.45±5.05)ng/mL、6.10(5.25,6.85)ng/mL、35.75(32.02,40.06)U/mL,良性病变组血清ALP、ANXA2、CEA及CA153水平分别为(81.26±11.95)U/L、(28.71±4.91)ng/mL、3.68(3.26,4.23)ng/mL、16.15(13.98,18.33)U/mL,均明显高于对照组[(73.47±11.71)U/L、(18.03±4.76)ng/mL、2.34(1.71,2.97)ng/mL、13.37(11.19,16.35)U/mL],且IDC组血清ALP、ANXA2水平均高于良性病变组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,ALP(OR=1.317)、ANXA2(OR=1.574)、CEA(OR=1.791)、CA153(OR=1.856),均为IDC发生的影响因素(P<0.05)。乳腺钼靶联合血清ALP和ANXA2与病理学诊断IDC的一致性(Kappa值=0.783)高于单独采用乳腺钼靶诊断(Kappa值=0.679)。ROC曲线显示,乳腺钼靶、血清ALP和ANXA2水平诊断IDC的敏感度分别为80.53%、66.58%、65.79%,特异度分别为89.45%、86.33%、85.55%,曲线下面积(AUC)分别为0.850、0.792、0.802,乳腺钼靶联合血清ALP、ANXAObjective To explore the early diagnostic value of breast molybdenum target combined with serum alkaline phosphatase(ALP)and annexin A2(ANXA2)expression levels for invasive ductal carcinoma(IDC)of the breast.Methods From June 2020 to September 2023,380 IDC patients admitted to Ezhou Central Hospital were prospectively regarded as the IDC group,and 256 patients with benign breast diseases admitted to our hospital period were regarded as the benign lesion group.Another 215 women who underwent health examinations in our hospital at the same period were collected as the control group.The clinical data and mammographic characteristics of patients in the IDC group and the benign lesion group were collected and compared;the serum ALP,ANXA2,carcinoembryonic antigen(CEA)and carbohydrate antigen(CA)153 levels were compared among the control group,the benign lesion group and the IDC group;multivariate Logistic regression model was used to analyze the influencing factors of IDC;the value of breast mammography combined with serum ALP and ANXA2 levels in diagnosing IDC was evaluated by the receiver operator charactoristic(ROC)curve.Results The percentages of blurred edges,marginal burrs,sediment calcification,irregular shape and breast structure disorder in IDC group were 35.53%,24.21%,16.05%,23.16%and 33.42%,respectively,which were significantly higher than those in benign lesion group(13.28%,8.98%,3.91%,7.42%and 4.69%),the differences were statistically significant(P<0.05).The levels of serum ALP,ANXA2,CEA,CA153 in the IDC group were(91.63±12.39)U/L,(36.45±5.05)ng/mL,6.10(5.25,6.85)ng/mL,35.75(32.02,40.06)U/mL,respectively,the levels of serum ALP,ANXA2,CEA,CA153 in the benign lesion group were(81.26±11.95)U/L,(28.71±4.91)ng/mL,3.68(3.26,4.23)ng/mL,16.15(13.98,18.33)U/mL,respectively,which were higher than those in the control group[(73.47±11.71)U/L,(18.03±4.76)ng/mL,2.34(1.71,2.97)ng/mL,13.37(11.19,16.35)U/mL],respectively,the levels of serum ALP and ANXA2 in IDC group were higher than those in benign lesion group,and

关 键 词：碱性磷酸酶 膜联蛋白A2 诊断 乳腺浸润性导管癌 乳腺钼靶 

分 类 号：R737.9[医药卫生—肿瘤]