目的:探讨超声造影参数在乳腺癌临床诊断中的价值及与血清肿瘤标志物表达的关系。方法:选取2017年10月至2019年6月丽水市人民医院收治的乳腺癌患者76例为恶性组，同期76例乳腺良性病变患者为良性组进行回顾性分析。2组均施行超声造影检查，并采用电化学发光法测定血清肿瘤标志物[糖链抗原153(CA153)、癌胚抗原(CEA)、组织多肽特异性抗原(TPS)、细胞角蛋白19片段抗原21-1(CYFRA21-1)]表达。对比恶性组、良性组超声造影定量参数(峰值强度、达峰时间)、血清CA153、CEA、TPS、CYFRA21-1水平，应用logistic回归分析探讨乳腺癌发病影响因素，受试者工作特征(ROC)曲线分析超声造影定量参数(峰值强度、达峰时间)对乳腺癌的诊断价值，Spearman相关分析乳腺癌患者超声造影参数与血清各肿瘤标志物关系。结果:恶性组超声造影的峰值强度高于良性组，达峰时间短于良性组(n P<0.05)；ROC分析显示，超声造影参数中峰值强度诊断乳腺癌的AUC小于达峰时间，当达峰时间截断值为≤20.15 s时，诊断灵敏度为60.53%，特异度为88.16%(n P<0.05)；恶性组血清CA153、CEA、TPS、CYFRA21-1水平均高于良性组(n P<0.05)；logistic回归分析显示，血清CA153、CEA、TPS、CYFRA21-1均为乳腺癌发病的重要危险因素(n P<0.05)；相关分析显示，乳腺癌患者超声造影参数中峰值强度与血清CA153、CEA、TPS、CYFRA21-1水平呈正相关(n r＝0.714，0.753，0.682，0.597，n P<0.05)，达峰时间与血清CA153、CEA、TPS、CYFRA21-1水平呈负相关(n r＝-0.693，-0.726，-0.652，-0.559，n P<0.05)。n 结论:乳腺癌超声造影参数值与乳腺良性病变具有较大差异，且与血清肿瘤标志物具有密切关系，可作为疾病诊断、病情评价的重要手段。“,”Objective:To investigate the value of contrast-enhanced ultrasound (CEUS) parameters in the clinical diagnosis of breast cancer and its correlation with serum tumor markers.Methods:From October 2017 to June 2019, 76 patients with breast cancer in Lishui People′s Hospital were selected as malignant group, and 76 patients with benign breast disease during the same period were selected as benign group for retrospective study. Both groups underwent contrast-enhanced ultrasound examination, and the expression of serum tumor markers [carbohydrate antigen 153 (CA153), carcinoembryonic antigen (CEA), tissue polypeptide specific antigen (TPS), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1)] were measured by electrochemiluminescence. The quantitative parameters (peak intensity, peak time), serum CA153, CEA, TPS, CYFRA21-1 levels in the malignant group and benign group were compared. Logistic regression analysis was used to explore the influencing factors of breast cancer. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of contrast-enhanced ultrasound quantitative parameters (peak intensity and time to peak) in breast cancer. Spearman correlation analysis was used to explore the relationship between CEUS parameters and serum tumor markers in breast cancer patients.Results:The peak intensity of contrast-enhanced ultrasound in the malignant group was higher than that in the benign group, and the peak time was shorter than that in the benign group (n P<0.05); ROC analysis showed that the AUC of peak intensity was less than the AUC of time to peak in the diagnosis of breast cancer. When the cutoff value of time to peak was ≤ 20.15 s, the diagnostic sensitivity was 60.53%, and the specificity was 88.16% (n P<0.05); the serum CA153, CEA, TPS, and CYFRA21-1 levels in the malignant group were higher than those in the benign group (n P<0.05); logistic regression analysis showed that serum CA153, CEA, TPS, and CYFRA21-1 were all important risk factors for breast cancer (n P<0.05); correlation analysis showed that the peak intensity in contrast-enhanced ultrasound parameters of breast cancer patients was significantly positively correlated with serum CA153, CEA, TPS, and CYFRA21-1 levels (n r=0.714, 0.753, 0.682, 0.597, n P<0.05), and the peak time was significantly negatively correlated with serum CA153, CEA, TPS, and CYFRA21-1 levels (n r=-0.693, -0.726, -0.652, -0.559, n P<0.05).n Conclusions:The contrast-enhanced parameters of breast cancer are significantly different from those of benign breast lesions, and they are closely related to serum tumor markers, which can be used as an important means for disease diagnosis and disease evaluation.