中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2013年
3期
203-206
,共4页
范光磊%万仁明%彭鸣亚%栾玉芬%赵骏%刘建文%徐龙宝
範光磊%萬仁明%彭鳴亞%欒玉芬%趙駿%劉建文%徐龍寶
범광뢰%만인명%팽명아%란옥분%조준%류건문%서룡보
乳腺肿瘤%骨肿瘤%肿瘤转移%癌胚抗原%抗原,肿瘤相关,碳水化合物
乳腺腫瘤%骨腫瘤%腫瘤轉移%癌胚抗原%抗原,腫瘤相關,碳水化閤物
유선종류%골종류%종류전이%암배항원%항원,종류상관,탄수화합물
Breast neoplasms%Bone neoplasms%Neoplasm metastasis%Carcinoembryonic antigen%Antigens,tumor-associated,carbohydrate
目的 探讨CEA、CA15-3及骨转换生化标志物总Ⅰ型前胶原氨基端延长肽(TPINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、PTH和ALP在乳腺癌骨转移诊断中的意义.方法 对2011年1月至2012年6月经病理或细胞学确诊的78例乳腺癌女性患者[年龄(56.72±10.76)岁]测定血清CEA、CA15-3、TP INP、β-CTx、PTH和ALP,并测Gleason评分,行放射性核素骨显像,根据显像结果将患者分成骨转移组(32例)与非骨转移组(46例).采用ROC曲线评估各标志物在诊断乳腺癌骨转移中的价值.以两样本t检验检测组间差异,用Pearson相关分析和logistic回归分析检测各指标与乳腺癌骨转移的关系.结果 乳腺癌骨转移组CEA 、CA15-3、TPINP、β-CTx、PTH和ALP血清浓度均显著高于非骨转移组(t值4.16 ～7.56,均P＜0.05).CEA、CA15-3、TPI NP、β-CTx、PTH和ALP诊断乳腺癌骨转移的AUC分别为0.815、0.887、0.869、0.852、0.844和0.731,其灵敏度分别为56.3％(18/32)、75.0％ (24/32)、78.1％(25/32)、81.3％ (26/32)、78.1％ (25/32)和68.8％(22/32),特异性为80.4％(37/46)、84.8％ (39/46)、76.1％ (35/46)、78.3％(36/46)、69.6％(32/46)和58.7％(27/46).CEA、CA15-3、TP I NP、β-CTx、PTH、ALP、Gleason评分与乳腺癌患者骨转移的发生呈正相关(r值为0.267 ～0.636,均P＜0.05).CEA、CA15-3、TPI NP、β-CTx、PTH与Gleason评分是预测乳腺癌骨转移的危险因素(比值比分别为2.45、3.44、1.24、1.54、1.11和2.22,均P＜0.05),发生骨转移的总符合率为81.3％ (26/32).结论 CEA、CA15-3、TPINP、β-CTx、PTH诊断乳腺癌骨转移的价值相当,联合检测有利于乳腺癌骨转移的早期诊断.
目的 探討CEA、CA15-3及骨轉換生化標誌物總Ⅰ型前膠原氨基耑延長肽(TPINP)、Ⅰ型膠原羧基耑肽β特殊序列(β-CTx)、PTH和ALP在乳腺癌骨轉移診斷中的意義.方法 對2011年1月至2012年6月經病理或細胞學確診的78例乳腺癌女性患者[年齡(56.72±10.76)歲]測定血清CEA、CA15-3、TP INP、β-CTx、PTH和ALP,併測Gleason評分,行放射性覈素骨顯像,根據顯像結果將患者分成骨轉移組(32例)與非骨轉移組(46例).採用ROC麯線評估各標誌物在診斷乳腺癌骨轉移中的價值.以兩樣本t檢驗檢測組間差異,用Pearson相關分析和logistic迴歸分析檢測各指標與乳腺癌骨轉移的關繫.結果 乳腺癌骨轉移組CEA 、CA15-3、TPINP、β-CTx、PTH和ALP血清濃度均顯著高于非骨轉移組(t值4.16 ～7.56,均P＜0.05).CEA、CA15-3、TPI NP、β-CTx、PTH和ALP診斷乳腺癌骨轉移的AUC分彆為0.815、0.887、0.869、0.852、0.844和0.731,其靈敏度分彆為56.3％(18/32)、75.0％ (24/32)、78.1％(25/32)、81.3％ (26/32)、78.1％ (25/32)和68.8％(22/32),特異性為80.4％(37/46)、84.8％ (39/46)、76.1％ (35/46)、78.3％(36/46)、69.6％(32/46)和58.7％(27/46).CEA、CA15-3、TP I NP、β-CTx、PTH、ALP、Gleason評分與乳腺癌患者骨轉移的髮生呈正相關(r值為0.267 ～0.636,均P＜0.05).CEA、CA15-3、TPI NP、β-CTx、PTH與Gleason評分是預測乳腺癌骨轉移的危險因素(比值比分彆為2.45、3.44、1.24、1.54、1.11和2.22,均P＜0.05),髮生骨轉移的總符閤率為81.3％ (26/32).結論 CEA、CA15-3、TPINP、β-CTx、PTH診斷乳腺癌骨轉移的價值相噹,聯閤檢測有利于乳腺癌骨轉移的早期診斷.
목적 탐토CEA、CA15-3급골전환생화표지물총Ⅰ형전효원안기단연장태(TPINP)、Ⅰ형효원최기단태β특수서렬(β-CTx)、PTH화ALP재유선암골전이진단중적의의.방법 대2011년1월지2012년6월경병리혹세포학학진적78례유선암녀성환자[년령(56.72±10.76)세]측정혈청CEA、CA15-3、TP INP、β-CTx、PTH화ALP,병측Gleason평분,행방사성핵소골현상,근거현상결과장환자분성골전이조(32례)여비골전이조(46례).채용ROC곡선평고각표지물재진단유선암골전이중적개치.이량양본t검험검측조간차이,용Pearson상관분석화logistic회귀분석검측각지표여유선암골전이적관계.결과 유선암골전이조CEA 、CA15-3、TPINP、β-CTx、PTH화ALP혈청농도균현저고우비골전이조(t치4.16 ～7.56,균P＜0.05).CEA、CA15-3、TPI NP、β-CTx、PTH화ALP진단유선암골전이적AUC분별위0.815、0.887、0.869、0.852、0.844화0.731,기령민도분별위56.3％(18/32)、75.0％ (24/32)、78.1％(25/32)、81.3％ (26/32)、78.1％ (25/32)화68.8％(22/32),특이성위80.4％(37/46)、84.8％ (39/46)、76.1％ (35/46)、78.3％(36/46)、69.6％(32/46)화58.7％(27/46).CEA、CA15-3、TP I NP、β-CTx、PTH、ALP、Gleason평분여유선암환자골전이적발생정정상관(r치위0.267 ～0.636,균P＜0.05).CEA、CA15-3、TPI NP、β-CTx、PTH여Gleason평분시예측유선암골전이적위험인소(비치비분별위2.45、3.44、1.24、1.54、1.11화2.22,균P＜0.05),발생골전이적총부합솔위81.3％ (26/32).결론 CEA、CA15-3、TPINP、β-CTx、PTH진단유선암골전이적개치상당,연합검측유리우유선암골전이적조기진단.
Objective To evaluate the significance of tumor markers CEA and CA15-3,and biochemical markers of bone turnover (total procol]agen type Ⅰ amino-terminal propeptide (TP I NP),β-isomerized carboxyterminal propeptide (β-CTx),ALP and PTH) in the diagnosis of bone metastasis from breast cancer.Methods A total of 78 patients (all females) with mean age (56.72 ± 10.76) years,who were diagnosed with breast cancer,were included in this study.The patients were divided into two groups based on radionuclide bone imaging:with bone metastasis (n =32) and without bone metastasis (n =46).The serum concentrations of CEA,CA15-3,TP I NP,[β-CTx,PTH,ALP were measured.Gleason scores were evaluated.The diagnostic value was evaluated by ROC curve.The two groups were compared using two-sample t test.The correlations between bone metastasis and tumor markers,bone metastasis and biochemical markers of bone turnover were analyzed with Pearson correlation and logistic analysis.Results The serum levels of CEA,CA15-3,TPINP,β-CTx,PTH and ALP were significantly higher in the group with bone metastasis than those in the group without bone metastasis (t:4.16-7.56,all P ＜ 0.05).For the diagnosis of bone metastasis from breast cancer,the AUC of CEA,CA15-3,TPINP,[β-CTx,PTH and ALP was 0.815,0.887,0.869,0.852,0.844,0.731,respectively.Using the cut-off values of 4.18 μg/L for CEA,0.04 U/L for CA15-3,49.70 μg/L for TP I NP,0.47 pg/L for β-CTx,54.90 ng/L for PTH and 49.90 U/L for ALP,the sensitivities were 56.3％ (18/32),75.0％ (24/32),78.1％ (25/32),81.3％ (26/32),78.1％ (25/32),68.8％ (22/32) and the specificities were 80.4％ (37/46),84.8％ (39/46),76.1％ (35/46),78.3％ (36/46),69.6％ (32/46),58.7％ (27/46),respectively.CEA,CA15-3,TPINP,β-CTx,PTH,ALP and Gleason score were positively correlated with the presence of bone metastasis (r:0.267-0.636,all P ＜ 0.05).CEA,CA15-3,TP I NP,β-CTx,PTH and Gleason score were independent predictors for bone metastasis of breast cancer (odds ratios:2.45,3.44,1.24,1.54,1.11,2.22,all P ＜0.05).The total coincidence rate of regression model was 81.3％ (26/32) in patients with bone metastasis.Conclusions The diagnostic values of CEA,CA15-3,TP I NP,β-CTx and PTH are comparable.Combined use of these parameters may be helpful for the early diagnosis of bone metastasis from breast cancer.
