肿瘤标志物对女性生殖道癌及乳腺癌联合筛查的临床价值

doi:10.3969/j.issn.1673-8640.2018.06.011

摘要/Abstract

摘要：

目的探讨血清甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原199（CA199）、糖类抗原153（CA153）、糖类抗原125（CA125）联合检测对女性生殖道癌及乳腺癌的诊断价值。方法选取女性生殖道癌及乳腺癌患者（癌症组）55例、良性炎症患者55例、健康普查者55名,分别检测其血清AFP、CEA、CA199、CA153、CA125水平,分析各组间结果的差异,并比较5项指标单独或联合检测诊断女性生殖道癌及乳腺癌的敏感性和特异性。结果癌症组AFP、CEA 、CA199、CA153、CA125水平显著高于良性炎症组和健康普查组（P<0.05）。5项指标联合检测诊断女性生殖道癌及乳腺癌的敏感性、特异性均明显高于单项检测。结论 5项肿瘤标志物联合检测对女性生殖道癌及乳腺癌具有较高的诊断价值,有助于疾病的早期筛查和早期诊断。

关键词: 肿瘤标志物, 女性生殖道癌, 乳腺癌, 化学免疫发光法

Abstract:

Objective To investigate the diagnostic role of the combined determination of serum alpha fetoprotein（AFP）,carcinoembryonic antigen（CEA）,carbohydrate antigen 199（CA199）,carbohydrate antigen 153（CA153）and carbohydrate antigen 125（CA125） in female genital tract cancer and breast cancer. Methods Totally,55 female genital tract cancer and breast cancer patients,55 benign inflammatory patients and 55 healthy subjects were enrolled. Serum levels of AFP,CEA,CA199,CA153 and CA125 were determined,and the results were analyzed statistically. The sensitivities and specificities of the 5 markers for the diagnosis of female genital tract cancer and breast cancer were compared. Results The levels of AFP,CEA,CA199,CA153 and CA125 in cancer group were higher than those in benign inflammatory and healthy control groups（P<0.05）. The sensitivity and specificity of the combined determination of the 5 markers were higher than those of the single determinations. Conclusions The combined determination of the 5 markers has a diagnostic value in the screening of female genital tract cancer and breast cancer,and it is helpful for early screening and early diagnosis.

Key words: Tumor marker, Female genital tract cancer, Breast cancer, Chemiluminescence

中图分类号:

R446.62

吴永春. 肿瘤标志物对女性生殖道癌及乳腺癌联合筛查的临床价值[J]. 检验医学, 2018, 33(6): 512-515.

WU Yongchun. Tumor markers for the combined screening of female genital tract cancer and breast cancer[J]. Laboratory Medicine, 2018, 33(6): 512-515.

图/表 4

参考文献 14

[1]	傅丽敏,程雪,张小薇. 血清肿瘤标记物癌胚抗原、CA153和CA125检测对乳腺癌的临床诊断价值[J]. 中国现代医生,2016,54(20):104-107.
[2]	张蕾,薛永飞,任中海. 血清肿瘤标志物联合检测对乳腺癌的诊断价值[J]. 中国妇幼保健,2015,30(15):2453-2455.
[3]	皮亚平,田柳. 肿瘤标志物CA153、CA125联合检查对乳腺癌诊断的价值分析[J]. 实用癌症杂志,2017,32(8):1351-1353.
[4]	黄之训,李桂圆,张惠芳,等. 肿瘤标志物联合筛查的临床意义[J]. 医药前沿,2016,6(1):51-52.
[5]	邓伟伟,黄艳春,阿先古丽·阿不力孜. 肿瘤标记物联合检测对肿瘤高危人群筛查的临床意义[J]. 国际免疫学杂志,2016,39(1):29-33.
[6]	杨泽安. CEA、CA125及CA153在乳腺癌中的检测价值[J]. 湖南师范大学学报(医学版),2016,13(3):83-84.
[7]	曾赛田,郭亮,刘世凯,等. 血清肿瘤标志物CA125、CA153、CA199及癌胚抗原联合检测在卵巢癌早期诊断中的临床意义[J]. 中国保健营养(中旬刊),2014,24(3):1285-1286.
[8]	HUMPHRIS J L,CHANG D K,JOHNS A L,et al.The prognostic and predictive value of serum CA19.9 in pancreatic cancer[J]. Ann Oncol,2012,23(7):1713-1722.
[9]	吕蕾,冯雪. 血清CEA、CA125、CA153联合检测在乳腺癌诊断中的应用价值研究[J]. 中国医药科学,2013,3(8):121-122.
[10]	石文,邱峰,林莉,等. 3种肿瘤标志物检测在乳腺癌术后随访中的价值[J]. 检验医学与临床,2015,12(10):1356-1357.
[11]	PEDERSEN A C,SØRENSEN P D,JACOBSEN E H,et al. Sensitivity of CA 15-3,CEA and serum HER2 in the early detection of recurrence of breast cancer[J]. Clin Chem Lab Med,2013,51(7):1511-1519.
[12]	RIEDINGER J M,GOUSSOT V,DESMOULINS I,et al.CEA and early detection of relapse in breast cancer subtypes:comparison with CA 15-3[J]. Bull Cancer,2016,103(5):434-443.
[13]	DI GIOIA D,BLANKENBURG I,NAGEL D,et al.Tumor markers in the early detection of tumor recurrence in breast cancer patients:CA 125,CYFRA 21-1,HER2 shed antigen,LDH and CRP in combination with CEA and CA 15-3[J]. Clin Chim Acta,2016,461:1-7.
[14]	郑平燕. 外周血CEA、CA153、CA125在乳腺癌临床筛查中的应用[J]. 中国妇幼保健,2015,30(16):2520-2522.

组别	例数	AFP（ng/mL）	CEA（ng/mL）	CA199（U/mL）	CA153（U/mL）	CA125（U/mL）
癌症组	55	65.46±14.23^*	120.31±15.6^*	221.64±15.86^*	215.37±17.31^*	258.43±18.35^*
良性炎症组	55	8.95±3.37^#	2.95±1.04^#	45.37±12.63^#	56.48±10.46^#	41.29±8.71^#
健康普查组	55	3.57±1.27	1.97±0.73	13.58±7.26	22.49±5.47	2.53±0.92
F值		4.23	5.22	6.12	6.75	5.94
P值		<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	AFP（ng/mL）	CEA（ng/mL）	CA199（U/mL）	CA153（U/mL）	CA125（U/mL）
癌症组	55	65.46±14.23^*	120.31±15.6^*	221.64±15.86^*	215.37±17.31^*	258.43±18.35^*
良性炎症组	55	8.95±3.37^#	2.95±1.04^#	45.37±12.63^#	56.48±10.46^#	41.29±8.71^#
健康普查组	55	3.57±1.27	1.97±0.73	13.58±7.26	22.49±5.47	2.53±0.92
F值		4.23	5.22	6.12	6.75	5.94
P值		<0.05	<0.05	<0.05	<0.05	<0.05

项目	AFP	CEA	CA199	CA153	CA125	联合检测
敏感性	30.18	72.56	65.41	72.35	86.47	83.28
特异性	40.12	62.13	60.78	76.89	90.15	82.36

项目	AFP	CEA	CA199	CA153	CA125	联合检测
敏感性	30.18	72.56	65.41	72.35	86.47	83.28
特异性	40.12	62.13	60.78	76.89	90.15	82.36

项目	AFP	CEA	CA199	CA153	CA125	联合检测
敏感性	32.14	76.32	64.45	85.67	71.47	87.49
特异性	39.21	70.66	62.84	88.43	70.15	89.65