血清癌胚抗原、糖类抗原153与乳腺癌分级的关系及其诊断价值研究

Associations of serum CEA and CA-153 with breast cancer grades and their diagnostic value

摘要:

目的 探讨血清癌胚抗原（CEA）、糖类抗原153（CA-153）与乳腺癌分级的关系及其诊断价值。方法 选取2021年1月—2024年3月就诊于浙江中医药大学附属杭州市中医院和福建医科大学附属第一医院的97例乳腺癌患者作为疾病组，另取同期该院60例健康体检女性作为健康组。对比疾病组与健康组血清CEA、CA-153水平。根据改良Bloom-Richardson半定量法将疾病组患者按病理分级分为Ⅰ、Ⅱ、Ⅲ级，对比不同分级患者血清CEA、CA-153水平，采用受试者工作特征（ROC）曲线分析血清CA-153、CEA诊断乳腺癌分级的效能。结果 与健康组比较，疾病组患者血清CA-153、CEA水平均升高（P <0.05）。Ⅲ级患者血清CA-153、CEA水平均高于Ⅰ、Ⅱ级患者（P <0.05），Ⅱ级患者血清CA-153、CEA水平均高于Ⅰ级患者（P <0.05）。ROC曲线结果表明，血清CA-153、CEA单一及联合诊断乳腺癌分级的敏感性分别为77.42%（95% CI：0.685，0.842）、87.10%（95% CI：0.732，0.937）、80.65%（95% CI：0.719，0.914），特异性分别为71.21%（95% CI：0.653，0.885）、80.30%（95% CI：0.737，0.927）、90.91%（95% CI：0.815，0.963）。结论 血清CEA、CA-153在乳腺癌患者中高表达。随着乳腺癌患者的病理分级升高，其血清CEA、CA-153水平升高，且联合检测诊断乳腺癌分级的价值较高。

Abstract:

Objective To investigate the associations of serum carcinoembryonic antigen (CEA) and cancer antigen 153 (CA-153) with the grading of breast cancer and their diagnostic value.Methods Ninety-seven breast cancer patients who visited Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University and the First Affiliated Hospital of Fujian Medical University from January 2021 to March 2024 were included as the disease group. Another 60 healthy women who underwent health checkups in the same hospitals during the same period of time were selected as the healthy group. Serum levels of CEA and CA-153 were compared between the disease group and the healthy group. Based on pathology assessed using the modified Bloom-Richardson grading system, patients in the disease group were categorized into grades I, II, and III. The serum levels of CEA and CA-153 were compared among patients with different grades, and the diagnostic performance of serum CA-153 and CEA for breast cancer pathological grading was evaluated using receiver operating characteristic (ROC) curve analysis.Results Compared with the healthy group, serum levels of CA-153 and CEA were elevated in patients in the disease group (P < 0.05). Serum levels of CA-153 and CEA were also higher in patients with grade III tumors than in those with grade I and II tumors (P < 0.05), and they were even higher in patients with grade II tumors than those with grade I tumors (P < 0.05). The ROC curve analysis revealed that the sensitivity of serum CA-153, CEA, and their combination for diagnosing breast cancer grades was 77.42% (95% CI: 0.685, 0.842), 87.10% (95% CI: 0.732, 0.937), and 80.65% (95% CI: 0.719, 0.914), with the specificity being 71.21% (95% CI: 0.653, 0.885), 80.30% (95% CI: 0.737, 0.927), and 90.91% (95% CI: 0.815, 0.963), respectively.Conclusion Serum CEA and CA-153 are highly expressed in breast cancer patients. Their levels increase with higher pathological grades of breast cancer, and the combined detection of these markers demonstrates higher diagnostic value for breast cancer grading.