摘要
目的:分析血清肿瘤标志物和外周血免疫炎性指标在乳腺癌诊断中的价值。方法:选取2016年10月—2020年10月中山大学孙逸仙纪念医院收治的150例乳腺癌患者作为乳腺癌组,同时选取同期该院收治的100例乳腺良性疾病患者作为乳腺良性疾病组,并选取同期于该院行健康体检的100名正常女性作为健康对照组。比较三组受试者的血清肿瘤标志物,包括癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)和细胞角蛋白19片段(CYFRA21-1),比较三组外周血免疫炎性指标,包括中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、系统免疫炎性指数(SII)和全身炎性反应指数(SIRI)水平,采用多因素Logistic回归分析进行影响因素分析。采用受试者工作特征(ROC)曲线分析获取曲线下面积(AUC)和最佳临界值,计算临界值的敏感度和特异度。结果:乳腺癌组血清CEA、CA125、CA153、CYFRA21-1水平和外周血NLR、PLR、SII、SIRI水平均高于健康对照组和乳腺良性疾病组,外周血LMR水平低于健康对照组和乳腺良性疾病组,差异有统计学意义(P<0.05)。经点二列相关性分析结果显示,CEA、CA125、CA153、CYFRA21-1、NLR、PLR、SII、SIRI水平与乳腺癌呈正相关(r=0.349、0.336、0.462、0.669、0.466、0.302、0.474、0.442,均P<0.05),LMR水平与乳腺癌呈负相关(r=-0.285,P<0.05)。多因素Logistic逐步回归分析结果显示,CEA水平、CYFRA21-1水平和SII水平的升高是乳腺癌诊断的影响因素。ROC曲线分析结果显示,CEA、CYFRA21-1、SII单独诊断乳腺癌的AUC分别为0.706、0.894、0.779,三者联合诊断的AUC为0.926。结论:血清CEA、CYFRA21-1和外周血SII水平可用于早期乳腺癌的辅助诊断,且三者联合诊断的效能更高。
Objective To analyze the value of serum tumor markers and peripheral blood immune inflammatory markers in the diagnosis of breast cancer.Methods A total of 150 patients with breast cancer who were admitted to Sun Yat-sen Memorial Hospital of Sun Yat-sen University from October 2016 to October 2020 were selected as the breast cancer group,100 patients with benign breast diseases who were admitted to the hospital at the same time were selected as the benign breast disease group,and 100 normal women who were examined at the hospital at the same time were selected as the healthy control group.Compare the serum tumor markers of three groups of subjects,including carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153),and cytokeratin 19 fragment(CYFRA21-1).Compare the peripheral blood immune inflammatory indicators of the three groups,including neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR)Systemic immune inflammatory index(SII)and systemic inflammatory response index(SIRI)levels.Multivariate logistic regression analysis was used to analyze the influencing factors.Receiver operating characteristic(ROC)curve analysis was used to obtain the area under the curve(AUC)and the optimal critical value,and the sensitivity and specificity of the critical value were calculated.Results The serum CEA,CA125,CA153,CYFRA21-1 levels and the peripheral blood NlR,PlR,SII,SIRI levels in the breast cancer group were higher than those in the healthy control group and the benign breast disease group,and the peripheral blood lMR levels were lower than those in the healthy control group and the benign breast disease group,with statistical significance(P<0.05).By point binary correlation analysis,CEA,CA125,CA153,CYFRA21-1,NlR,PlR,SII,SIRI levels were positively correlated with breast cancer(r=0.349,0.336,0.462,0.669,0.466,0.302,0.474,0.442,all P<0.05),and lMR levels were negatively correlated with breast cancer(r=-0.285,P<0.05).Multivariate logistic stepwise regression analysis showed that the increase of CEA level,CYFRA21-1 level and SII level were the influencing factors for the diagnosis of breast cancer.The ROC curve analysis results showed that the AUC of CEA,CYFRA21-1 and SII separately diagnosed breast cancer was 0.706,0.894 and 0.779,respectively,and the AUC of the three combined diagnosis was 0.926.Conclusions The levels of serum CEA,CYFRA21-1 and peripheral blood SII can be used for the auxiliary diagnosis of early breast cancer,and the combined diagnosis of the three is more effective.
作者
刘雪玲
李青
LIU Xueling;LI Qing(Department of Laboratory,South Campus Clinic,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong 510275,China;Department of General Medicine,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong 510120,China)
出处
《医药前沿》
2023年第31期19-23,共5页
Journal of Frontiers of Medicine
关键词
乳腺癌
肿瘤标志物
免疫炎性指标
诊断效能
Breast cancer
Tumor marker
Immune-inflammatory indicator
Diagnostic efficiency
