乳腺癌患者血清TAP、CA153、CA125及CEA联合检测的临床意义

发布时间：2018-06-20 00:26

本文选题：乳腺癌 + 肿瘤异常蛋白　；参考：《新乡医学院》2017年硕士论文

【摘要】：背景乳腺癌是女性最常见的恶性肿瘤,及时明确的诊断对乳腺癌患者生存和生活质量有着非常重要的影响,所以迫切需要准确的诊断指标。最常用的血清肿瘤标志物是糖类抗原153(cancer antigen 153;CA153)、癌胚抗原(carcinoembryonic antigen;CEA)、糖类抗原125(Carbohydrate antigen 125;CA125),然而它们的灵敏度和特异度相对较低。尽管如此,它们在监测恶性肿瘤疗效、复发方面有特别的价值,乳腺放射等检查所不能替代。肿瘤标志物有快速、无创、简单的特点,在乳腺恶性肿瘤诊断和治疗起着越来越重要的作用。因此,如何利用分子生物学技术发现乳腺癌诊断率高的肿瘤标志物己成为目前临床的研究方向之一。目的通过检测乳腺癌患者血清肿瘤标志物肿瘤异常蛋白(Tumor abnormal protein;TAP)、CA153、CA125、CEA的表达水平,探讨四个指标联合检测在乳腺癌患者中的临床意义。方法选取2015年10月至2016年10月在新乡市中心医院收治的113例乳腺癌患者作为观察组,另选取我院同期收治的乳腺良性病变者33例及健康体检者57例作为对照组。应用电化学发光法检测CA153、CEA和CA125血清水平,应用TAP检测系统检测TAP水平。选用SPSS 19.0统计软件进行全部数据的统计学处理,计量资料测定结果以均数±标准差表示,组间比较采用t检验,计数资料及率的比较选用χ2检验。并应用灵敏度、特异度及正确率,评价本实验所纳入指标单独及联合诊断乳腺癌的效能。结果血清TAP、CA153、CA125及CEA均可作为乳腺癌诊断的参考指标,乳腺癌组分别与乳腺良性疾病对照组和健康对照组相比,血清TAP、CA153、CA125及CEA表达水平均有显著性差异(P0.05)。TAP、CA153、CA125和CEA在乳腺癌诊断中的正确率分别是61.58%、61.08%、52.71%、51.23%,灵敏度分别是34.51%、32.74%、21.24%、16.81%;特异度分别是95.56%、96.67%、90.00%、94.44%。单项指标检测中,TAP正确率最高,其值为61.58%,TAP灵敏度最高,其值为34.51%,CA153特异度最高,其值为96.67%。两项指标联合,TAP、CA153联合在六种组合中为较佳组合,正确率、灵敏度、特异度分别是68.47%、49.56%、92.22%。三个指标联合中,其中TAP、CA153、CEA三者联合在四种组合中的正确率、灵敏度、特异度均为最高,分别是68.47%、53.98%、86.67%。四个指标共同联合检测诊断性试验的灵敏度为:58.41%,特异度为76.67%,正确率为66.50%。将较佳的两项、三项、四项联合进行比较,根据择优法及实用性原则,TAP联合CA153为本研究乳腺癌诊断的最佳组合。治疗后(手术及化疗)乳腺癌患者的CA153、CA125、CEA的血清水平较治疗前有明显的降低,两组比较差异有统计学意义(P0.05),TAP在治疗前后差异不明显(P0.05)。TAP在1月后再次复查时和治疗前相比结果下降明显,差异有统计学意义(P0.05)。单因素分析显示,血清TAP与肿瘤大小、淋巴结转移状态以及组织病理学分期不相关(P0.05)。结论通过血清TAP、CA153、CA125和CEA四个指标的不同联合,可为乳腺癌辅助诊断提供帮助;在不同的指标组合中,TAP、CA153联合检测可作为乳腺癌辅助诊断的最优组合。
[Abstract]:Background breast cancer is the most common malignant tumor in women. Timely and clear diagnosis has a very important impact on the survival and quality of life of breast cancer patients. Therefore, accurate diagnostic indicators are urgently needed. The most commonly used serum tumor markers are carbohydrate antigen 153 (cancer antigen 153; CA153), carcinoembryonic antigen (carcinoembryonic antigen; CEA). Carbohydrate antigens 125 (Carbohydrate antigen 125; CA125), however, are relatively low in sensitivity and specificity. Nevertheless, they are of special value in monitoring the curative effect of malignant tumors and in the recurrence of breast radiology. The tumor markers have rapid, noninvasive, simple characteristics, and the diagnosis and treatment of breast cancer. It is becoming more and more important. Therefore, how to use molecular biology technology to detect tumor markers with high diagnostic rate of breast cancer has become one of the current clinical research directions. Objective to explore the expression level of Tumor abnormal protein (TAP), CA153, CA125 and CEA by detecting the serum tumor markers of breast cancer patients, four Methods 113 cases of breast cancer treated in Xinxiang Central Hospital from October 2015 to October 2016 were selected as observation group. 33 cases of benign breast lesions in our hospital and 57 cases of healthy persons were selected as control group. CA153, C were detected by electrochemiluminescence. The serum level of EA and CA125 was used to detect the level of TAP by TAP detection system. The statistical processing of all data was processed with SPSS 19 statistical software. The results of measurement data were expressed with mean standard deviation. T test was used for comparison between groups. The comparison of count data and rate was selected by the x 2 test. Results the serum TAP, CA153, CA125 and CEA could be used as a reference index for the diagnosis of breast cancer. Compared with the benign breast disease control group and the healthy control group, the serum TAP, CA153, CA125 and CEA expressed in the breast cancer group were significantly different (P0.05).TAP, CA153, CA125, and CEA. The correct rate in the diagnosis of breast cancer was 61.58%, 61.08%, 52.71%, 51.23%, and the sensitivity was 34.51%, 32.74%, 21.24%, 16.81% respectively. The specificity was 95.56%, 96.67%, 90%, and the 94.44%. was the highest, its value was 61.58%, the TAP sensitivity was the highest, and the value of CA153 was the highest, and its value was 96.67%. two finger. The combination of standard, TAP, and CA153 is a better combination of the six combinations. The accuracy, sensitivity, and specificity of the combination are 68.47%, 49.56%, and 92.22%., respectively, among which TAP, CA153, and CEA three are combined in the four combinations with the highest accuracy, sensitivity, and specificity, which are 68.47%, 53.98%, and four 86.67%., respectively. The sensitivity of the test was 58.41%, the specificity was 76.67%, the correct rate was 66.50%., the better two, three and four combined. According to the optimal method and the practical principle, TAP combined with CA153 was the best combination of the diagnosis of breast cancer in this study. The serum level of CA153, CA125, CEA in the patients with breast cancer after treatment (operation and chemotherapy) was compared with the treatment. The difference between the two groups was statistically significant (P0.05), and the difference of TAP before and after treatment was not obvious (P0.05), and the difference was significant (P0.05). The single factor analysis showed that serum TAP and tumor size, lymph node metastasis state and histopathology staging were found. No correlation (P0.05). Conclusion the combination of four indicators of serum TAP, CA153, CA125 and CEA can help diagnosis of breast cancer. In different combination of index, TAP, CA153 combined detection can be the best combination of breast cancer diagnosis.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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