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目的评价肿瘤标志物糖类抗原15-3(carbohydrate antigen,CA15-3)、癌胚抗原(carcino-embryonic antigen,CEA)在乳腺癌诊断与术后复发转移判断中的应用价值。方法采用化学发光免疫分析法测定110例乳腺癌患者、50例乳腺良性疾病患者及40例正常对照者的血清CA15-3、CEA水平。组间比较采用χ2检验。用ROC曲线评价CA15-3、CEA在乳腺癌诊断和术后复发转移判断中的应用价值。结果 110例患者中CA15-3和CEA阳性检出率分别为32.7%(36/110)和12.7%(14/110)。I期、II期乳腺癌患者CA15-3、CEA血清含量无明显变化,与良性组和正常对照组相比差异无统计学意义(P>0.050)。以43例Ⅲ期、Ⅳ期乳腺癌患者的CA15-3、CEA测定值绘制ROC曲线,分析显示,CA15-3、CEA的ROC曲线下面积(AUC)分别为82.3%、81.1%,95%可信区间分别为0.719～0.929、0.714～0.906。术后复发转移患者CA15-3、CEA阳性检出率分别为85.7%(18/21)、52.4%(11/21),AUC分别为97.8%、89.1%,95%可信区间分别为0.944～1.011、0.790～0.991。结论通过ROC曲线评价可得出,CA15-3、CEA对Ⅲ期、Ⅳ期乳腺癌诊断有临床参考价值,在术后复发转移诊断中有较高的应用价值,可作为乳腺癌术后监测复发转移的有效指标。
Objective To evaluate the value of tumor marker carbohydrate antigen (CA15-3) and carcinoembryonic antigen (CEA) in the diagnosis of breast cancer and the postoperative recurrence and metastasis. Methods The levels of serum CA15-3 and CEA in 110 cases of breast cancer, 50 cases of benign breast diseases and 40 cases of normal controls were determined by chemiluminescence immunoassay. Comparison between groups using χ2 test. The ROC curve was used to evaluate the value of CA15-3 and CEA in the diagnosis of breast cancer and the judgment of recurrence and metastasis. Results The positive rates of CA15-3 and CEA in 110 patients were 32.7% (36/110) and 12.7% (14/110), respectively. There was no significant difference in serum levels of CA15-3 and CEA between stage I and stage II breast cancer patients, but there was no significant difference between benign group and normal control group (P> 0.050). The ROC curves of CA15-3 and CEA in 43 stage Ⅲ and stage Ⅳ breast cancer patients were drawn. The area under the ROC curve of CA15-3 and CEA were 82.3%, 81.1% and 95%, respectively The confidence intervals are 0.719 ~ 0.929 and 0.714 ~ 0.906, respectively. The positive rates of CA15-3 and CEA in patients with recurrence and metastasis were 85.7% (18/21) and 52.4% (11/21), respectively. The AUCs were 97.8% and 89.1%, respectively. The 95% CIs were 0.944 ~ 1.011, 0.790 ~ 0.991. Conclusion According to the ROC curve evaluation, it is concluded that CA15-3 and CEA have clinical value in the diagnosis of stage Ⅲ and Ⅳ breast cancer, and have high value in diagnosis of postoperative recurrence and metastasis, which can be used as postoperative monitoring and recurrence of breast cancer Effective indicator of transfer.