庹有林

[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為0.886（95%CI 0.689～0.993），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。

[关键词] 乳腺癌；超声光散射成像；癌抗原15-3；癌胚抗原

[中图分类号] R737.9 [文献标识码] A [文章编号] 1673-7210（2017）09（b）-0090-04

Diagnostic value of breast ultrasound DOT combined with serum CA15-3 and CEA detection in breast tumors

TUO Youlin

Department of Breast Surgery， Sichuan Province People's Hospital， Sichuan Province， Chengdu 610072， China

[Abstract] 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.

[Key words] Breast cancer； Ultrasound DOT； Cancer antigen 15-3； Carcinoembryonic antigen

乳腺癌是女性中的高发性恶性肿瘤，近年来其发病率逐年上升，已经成为威胁女性身体健康和生命安全的头号杀手[1-2]。乳腺癌早期症状不明显，发现时已处于中晚期，如何在肿瘤早期及时发现和治疗对于提升疗效和改善患者预后十分关键。常规彩色多普勒对于乳腺肿瘤的毛细血管、滋养动脉和静脉等低流速、低流量的血管不能显示，光散射断层成像（DOT）是一种新型的成像技术，其利用人体不同组织对不同波长红外线的散射、发射和吸收不同，能够探测肿瘤内部，能及时的获取组织内血流、分子功能、代谢等多项参数[3-4]。血清癌抗原15-3（CA15-3）、癌胚抗原（CEA）是临床上常用的乳腺、呼吸道和消化道等系统肿瘤检测标志物，其对于乳腺癌的早期诊断和预后具有重要的临床价值。本研究探讨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，以期为临床乳腺癌的诊断提供一定指导。……