CAJ | 학술논문

目的探讨血清肿瘤标志物[肿瘤抗原15-3(CA15-3)、恶性肿瘤特异性生长因子(TSGF)、骨桥蛋白(OPN)和肿瘤抗原125(CA125)]联合检测在乳腺癌诊断和治疗中的价值.方法采用电化学发光法检测患者血清CA15-3和CA125、化学比色法检测TSGF及酶联免疫吸附试验法检测OPN水平,乳腺癌组(187例)与乳腺疾病良性对照组(50例)患者比较,分析各标志物与乳腺癌临床分期和复发转移的关系.对45例复发者比较血清肿瘤标志物与钼靶X线检出时间的差异.结果乳腺癌组患者血清CA15-3、CA125、TSGF和OPN明显高于良性对照组(P＜0.01);乳腺癌高分期(Ⅲ、Ⅳ期)组[四项指标分别为(83.21±28.67)、(89.13±32.42)、(278.66±137.23)U/ml和(97.4±11.7)ng/ml]明显高于良性对照组[(14.01±3.23)、(13.12±9.23)、(46.15±3.12)U/ml和(30.12±12.91)ng/ml]和低分期(Ⅰ、Ⅱ期)组[(60.03±19.35)、(58.21±17.46)、(155.79±113.11)U/ml和(77.5±10.81)ng/ml](P＜0.05);淋巴结转移组与无转移组、复发组与无复发组间差异有统计学意义(P＜0.05);CA15-3、TSGF、OPN和CA125联合检测的敏感度为96.3%(180/187),特异度为80.0%(40/50);复发组血清肿瘤标志物检测比钼铑双靶X线检测出肿块时间平均早2个月.结论 C A15-3、TSGF、OPN和CA125血清学联合检测是乳腺癌早期诊断和监控复发转移的较好指标,有利于临床早期发现、早期干预.
목적 탐토혈청종류표지물[종류항원15-3(CA15-3)、악성종류특이성생장인자(TSGF)、골교단백(OPN)화종류항원125(CA125)]연합검측재유선암진단화치료중적개치.방법 채용전화학발광법검측환자혈청CA15-3화CA125、화학비색법검측TSGF급매련면역흡부시험법검측OPN수평,유선암조(187례)여유선질병량성대조조(50례)환자비교,분석각표지물여유선암림상분기화복발전이적관계.대45례복발자비교혈청종류표지물여목파X선검출시간적차이.결과 유선암조환자혈청CA15-3、CA125、TSGF화OPN명현고우량성대조조(P＜0.01);유선암고분기(Ⅲ、Ⅳ기)조[사항지표분별위(83.21±28.67)、(89.13±32.42)、(278.66±137.23)U/ml화(97.4±11.7)ng/ml]명현고우량성대조조[(14.01±3.23)、(13.12±9.23)、(46.15±3.12)U/ml화(30.12±12.91)ng/ml]화저분기(Ⅰ、Ⅱ기)조[(60.03±19.35)、(58.21±17.46)、(155.79±113.11)U/ml화(77.5±10.81)ng/ml](P＜0.05);림파결전이조여무전이조、복발조여무복발조간차이유통계학의의(P＜0.05);CA15-3、TSGF、OPN화CA125연합검측적민감도위96.3%(180/187),특이도위80.0%(40/50);복발조혈청종류표지물검측비목로쌍파X선검측출종괴시간평균조2개월.결론 C A15-3、TSGF、OPN화CA125혈청학연합검측시유선암조기진단화감공복발전이적교호지표,유리우림상조기발현、조기간예.
Objective To explore the clinical value of combined detection of CA15-3, TSGF, OPN and CA125 in the diagnosis and treatment of breast cancer. Methods The serum specimens from 187 patients with breast cancer (cancer group) were collected, tumor markers CA15-3 and CA125 were detected with electrochemiluminescence method, TSGF was detected with chemocolorimetry, and OPN was detected with enzyme-linked immunosorbent assay. Compared with 50 cases of patients with benign breast disease (control group), The relationship between these marker and clinical stage, recurrence and metastasis of breast cancer were analyzed. Results The serum levels of CA15-3, CA125, TSGF and OPN in cancer group were significantly higher than those in control group (P ＜0.05). Four markers in high clinical stage(Ⅲ and Ⅳ stage)[(83.21±28.67), (89.13±32.34), (278.66±137.23) U/ml and (97.4±11.7) ng/ml, respectively] were higher than those in low stage( Ⅰ and Ⅱ stage) [(60.03±19.35), (58.21±17.56), (155.79±113.11) U/ml and (77.5±10.81) ng/ml,respectively] (P ＜0.05), and those in lymphnode metastasis patients and in recurrence patients were significantly higher than those in corresponding groups (P ＜0.05). The sensitivity and specificity of the combined detection of four tumor markers were 96.3 % (180/187) and 80.0 % (40/50), respectively. The average time of combined detection of serum tumor markers was 2 months ahead of the mammographic features in the recurrence patients with breast cancer. Conclusion The dynamic combined detection of CA15-3, TSGF, OPN and CA125 are better markers for monitoring recurrence and metastasis of breast cancer,which are benefit to early diagnosis and interference.