乳腺超声光散射成像联合血清CA15-3、CEA检测在乳腺肿瘤中的诊断价值

摘要

目的 探讨乳腺超声光散射成像联合血清癌抗原15-3(CA15-3)、癌胚抗原(CEA)检测在乳腺肿瘤中的诊断价值.方法 选取2012年8月～2015年12月四川省人民医院收治的136例女性乳腺癌患者为A组,女性乳腺良性肿瘤组120例为B组,体检的女性健康者120例作为正常对照的C组,检测分析三组最高血红蛋白(MHC)值、血清CA15-3和CEA水平.结果 A组患者的CA15-3和CEA水平显著高于B组和C组,差异有统计学意义(P＜0.05),后两者CA15-3、CEA水平比较,差异无统计学意义(P＞0.05).超声、联合血清CA15-3、CEA检测乳腺肿瘤的阳性率显著高于单一检测,差异有统计学意义(P＜0.05),超声、血清CA15-3和CEA联合检测乳腺癌敏感度明显高于任一单一检测,差异有统计学意义(P＜0.05).ROC曲线分析联合检测在诊断乳腺恶性肿瘤的AUC为0.886(95％CI0.689～0.993),最大诊断阙值为135.0 μmol/L时,约登指数最大值为0.70,特异度为91.5％,敏感度为95.5％.结论 乳腺超声光散射成像联合血清CA15-3、CEA检测可以弥补单一指标检查的缺陷,从而提高乳腺癌的确诊率,对乳腺癌具有良好的辅助诊断价值.%Objective To explore the diagnostic value of breast ultrasound DOT combined with serum CA15-3 and CEA detection in breast tumors.Mehtods From August 2012 to December 2015,in Sichuan Province People's Hospital,136 female breast cancer patients were selected as group A,120 female benign breast tumor patients were selected as group B,120 female healthy physical examination were selected as group C,the MHC,serum CA15-3 and CEA levels in three groups were detected and analyzed.Results The levels of CA15-3 and CEA in group A were significantly higher than those in group B and group C,the differences were statistically significant (P ＜ 0.05),CA15-3 and CEA levels in group B and group C were compared,the differences were not statistically significant (P ＞ 0.05).Ultrasound,combined serum CA15-3,CEA detecting breast tumor positive rate was significantly higher than the respective single detecting,the differences were statistically significant (P ＜ 0.05),ultrasound,combined serum CA15-3,CEA detecting breast cancer sensitivity rate was significantly higher than the respective single detecting,the differences were statistically significant (P ＜ 0.05).ROC curve analysis of joint detection in the diagnosis of breast malignant tumor AUC was 0.886 (95％CI 0.689-0.993),the maximum diagnostic threshold was 135.0 μmol/L,the maximum value of Youden's index was 0.70,the specificity was 91.5％,sensitivity was 95.5％.Conclusion Breast ultrasound DOT combined with serum CA15-3,CEA detection can make up for the defect of single index examination,so as to improve the diagnosis rate of breast cancer,breast cancer has good auxiliary diagnostic value.