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山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (2): 72-78.doi: 10.6040/j.issn.1671-7554.0.2019.1154

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外周血循环肿瘤细胞、糖类抗原153、糖类抗原125、癌胚抗原检测对105例乳腺导管原位癌或伴微小浸润癌的诊断价值

官燕飞1,陈志强2,袁春雷1,彭建明1,米贤军2,刘君3,陈昂2,袁斌1,刘子成1   

  1. 1. 南方医科大学附属中山博爱医院检验科, 广东 中山 528400;2. 南方医科大学附属中山博爱医院病理科, 广东 中山 528400;3. 中山大学肿瘤防治中心病理科, 广东 广州 510060)
  • 出版日期:2020-02-10 发布日期:2022-09-27
  • 通讯作者: 陈昂. E-mail:361782947@qq.com
  • 基金资助:
    广东省医学科学技术研究基金(A2019348);中山市社会公益科技研究专项(2019B1090)

Detection of tumor cells, carbohydrate antigen 153, carbohydrate antigen 125 and carcinoembryonic antigen in peripheral blood circulation in 105 cases of ductal carcinoma in situ or with minimal invasive carcinoma

GUAN Yanfei1, CHEN Zhiqiang2, YUAN Chunlei1, PENG Jianming1, MI Xianjun2, LIU Jun3, CHEN Ang2, YUAN Bin1, LIU Zicheng1   

  1. 1. Department of Clinical Laboratory, Zhongshan BOAI Hospital Affiliated to Southern Medical University, Zhongshan 528400, Guangdong, China;
    2. Department of Pathology, Zhongshan BOAI Hospital Affiliated to Southern Medical University, Zhongshan 528400, Guangdong, China;
    3. Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, China
  • Online:2020-02-10 Published:2022-09-27

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摘要： 目的 探究外周血循环肿瘤细胞(CTC)、糖类抗原153(CA153)、糖类抗原125(CA125)、癌胚抗原(CEA)单独和联合检测在乳腺导管原位癌(DCIS)或伴微小浸润癌中的诊断价值。 方法 选取136例乳腺良性病变患者(良性组)、105例DCIS或伴微小浸润癌患者(恶性组)和151例健康体检者(对照组)作为研究对象,采用免疫荧光原位杂交技术(IMFISH)测定CTC数量,采用电化学发光法测定CA153、CA125、CEA数值,分析上述检测指标单独检测法(CA153、CA125、CEA和CA153+CA125+CEA)和联合检测法(CTC+CA153+CA125+CEA)诊断DCIS或伴微小浸润癌的价值。 结果 (1)单独检测和联合检测法的恶性组阳性率与对照组、良性组相比,差异均有统计学意义(P<0.01);(2)恶性组的联合检测法阳性率与单独检测法相比,差异均有统计学意义(P<0.001);(3)恶性组的CTC、CA153、CA125检测值均最大,与对照组、良性组相比,差异均有统计学意义(P<0.001);(4)联合检测法的灵敏度、特异度、符合率与单独检测法相比,差异均有统计学意义(P<0.001);(5)CTC、CA153、 CA125、 CEA、CA153+CA125+CEA、CTC+CA153+CA125+CEA检测法的曲线下面积分别为0.873、0.803、0.775、0.760、0.900、0.959。 结论 CTC+CA153+CA125+CEA联合检测对DCIS或伴微小浸润癌的诊断具有更高的灵敏度、符合率,更大的ROC曲线的诊断面积,同时仍能维稳较好的特异度。

关键词: 循环肿瘤细胞, 糖类抗原153, 糖类抗原125, 癌胚抗原, 导管原位癌, 微小浸润癌, 肿瘤标志物

Abstract: Objective To explore the diagnostic value of peripheral blood circulation tumor cell(CTC), carbohydrate antigen 153(CA153), carbohydrate antigen 125(CA125), carcinoembryonic antigen(CEA)on single or combined detection of ductal carcinoma in situ(DCIS)or with microinvasive carcinoma. Methods A total of 136 patients with benign breast disease(benign group), 105 patients with DCIS or with micro invasive cancer(malignant group)and 151 healthy people(control group)were selected as the study objects. The amount of CTC was measured by immunofluorescence in situ hybridization(IMFISH). The values of CA153, CA125 and CEA were measured by electrochemiluminescence. The value of single detection(CA153, CA125, CEA and CA153+CA125+CEA)and combined detection(CTC+CA153+CA125+CEA)in diagnosing DCIS or micro invasive cancer was analyzed. Results (1)For all the detection methods, the positive rate of malignant group was significantly higher than those in benign group and control group(P<0.01). (2)Compared with the single detection methods, the positive rate of combined detection method in malignant group was significantly higher(all P<0.001). (3) Compared with the control group and benign group, the detection values of CTC, CA153 and CA125 methods in malignant group were higher(P<0.001). (4) The sensitivity, specificity and coincidence rate were significantly different among the combined detection method and the single detection methods(P<0.001). (5) The areas under the curve of CTC, CA153, CA125, CEA,(CA153+CA125+CEA)and(CTC+CA153+CA125+CEA)detections were 0.873, 0.803, 0.775, 0.760, 0.900 and 0.959, respectively. Conclusion CTC+CA153+CA125+CEA detection method has a higher sensitivity and coincidence rate in the diagnosis of DCIS or with micro invasive cancer, larger diagnostic area of ROC curve and a better specificity.

Key words: Circulating tumor cell, Carbohydrate antigen 153, Carbohydrate antigen 125, Carcinoembryonic antigen, Ductal carcinoma in situ, Minimally invasive carcinoma, Tumor markers

中图分类号: 

  • R446.1
[1] Wen D, Wen X, Yang Y, et al. Urban rural disparity in female breast cancer incidence rate in China and the increasing trend in parallel with socioeconomic development and urbanization in a rural setting[J]. Thorac Cancer, 2018, 9(2): 262-272.
[2] Low SK, Zembutsu H, Nakamura Y.Breast cancer:the translation of big genomic data to cancer precision medicine[J]. Cancer Sci, 2018, 109(3):497-506.
[3] 张瑾, 陈薇, 刘蕾.2017年《NCCN乳腺癌筛查和诊断临床实践指南》(第1版)更新与解读[J].中国全科医学, 2017, 20(24):2939-2943. ZHANG Jin, CHEN Wei, LIU Lei. Update and interpretation of NCCN breast cancer screening and diagnosis clinical practice guide(version 1)2017[J]. Chinese General Medicine, 2017, 20(24):2939-2943.
[4] 何伟明, 吴庆金, 何玉清.女性肿瘤标志物联合检测的研究现状及其应用前景[J].中国肿瘤生物治疗杂志, 2018, 25(2):192-197. HE Weiming, WU Qingjin, HE Yuqing. Research status and application prospect of combined detection of female tumor markers[J].Chinese Journal of tumor biotherapy, 2018, 25(2):192-197.
[5] 唐林, 陈巍魏, 管晓翔.AJCC第8版乳腺癌分期系统更新的解读[J]. 临床肿瘤学杂志, 2017, 22(11):1038-1040. TANG Lin, CHEN Weiwei, GUAN Xiaoxiang. Interpretation of AJCC 8th Edition breast cancer staging system update[J].Journal of Clinical Oncology, 2017, 22(11):1038-1040.
[6] 周斌, 辛灵, 徐玲, 等.乳腺癌液体活检的现状与前景[J].中华外科杂志, 2018, 56(2): 106-109. ZHOU Bin, XIN Ling, XU Ling, et al. The present situation and Prospect of breast cancer liquid biopsy[J]. Chinese Journal of Surgery, 2018, 56(2): 106-109.
[7] Lakhani SR, Ellis IO, Schnitt SJ, et al. WHO classification of tumours of the breast[M]. Lyon:IARC Press, 2012.
[8] 田晓坤, 李玉明, 胡宝光, 等.胃癌患者外周血Cyttel循环肿瘤细胞检测及临床意义[J].中华实验外科杂志, 2017, 34(2): 208-210. TIAN Xiaokun, LI Yuming, HU Baoguang, et al. Detection of circulating tumor cells in peripheral blood of patients with gastric cancer and its clinical significance[J].Chinese Journal of Experimental Surgery, 2017, 34(2): 208-210.
[9] Lancaster RB, Gulla S, De Los Santos J, et al.Breast cancer screening and optimizing recommendations[J].Semin Roentgenol, 2018, 53(4): 280-293.
[10] Lebron-Zapata L, Jochelson MS. Overview of breast cancer screening and diagnosis[J]. PET Clin, 2018, 13(3):301-323.
[11] Huebner H, Fasching PA, Gumbrecht W, et al. Filtration based assessment of CTCs and CellSearch based assessment are both powerful predictors of prognosis for metastatic breast cancer patients[J]. BMC Cancer, 2018, 18(1): 204-204.
[12] 杨文蔚, 王志恒, 岳朝艳.乳腺癌患者血清CA153、CEA、铁蛋白和降钙素水平的变化及临床意义[J].检验医学, 2017, 32(4):308-310. YANG Wenwei, WANG Zhiheng, YUE Zhaoyan. Changes and clinical significance of serum CA153, CEA, ferritin and calcitonin levels in patients with breast cancer[J]. Laboratory Medicine, 2017, 32(4):308-310.
[13] 易琳, 刘兴明, 林丁, 等. 血清CAl53、CAl25、CEA联合检测在乳腺癌诊断中的价值[J].重庆医科大学学报, 2012, 37(9):802-805. YI Lin, LIU Xingming, LIN Ding, et al. The value of combined detection of serum cal53, CAl25 and CEA in the diagnosis of breast cancer[J]. Journal of Chongqing Medical University, 2012, 37(9):802-805.
[14] 张晓洁, 张美娟, 张立涛, 等. CEA 、CA153 、CYFRA21-1 、CRP联合检测在乳腺癌辅助诊断中的临床价值探讨[J].国际检验医学杂志, 2017, 38(23):3352-3354. ZHANG Xiaojie, ZHANG Meijuan, ZHANG Litao, et al. The clinical value of CEA, CA153, CYFRA21-1 and CRP in the diagnosis of breast cancer[J].International Journal of Laboratory Medicine, 2017, 38(23):3352-3354.
[15] Jafari SH, Saadatpour Z, Salmaninejad A, et al. Breast cancer diagnosis: imaging techniques and biochemical markers[J]. J Cell Physiol, 2018, 233(7):5200-5213.
[16] Bayo J, Casta(~overn)o MA, Rivera F, et al. Analysis of blood markers for early breast cancer diagnosis[J]. Clin Transl Oncol, 2018, 20(4):467-475.
[17] 陈志强, 米贤军, 陈昂, 等.外周血循环肿瘤细胞检测在筛查卵巢上皮性癌中的应用[J].中山大学学报(医学版), 2018, 39(6):891-896. CHEN Zhiqiang, MI Xianjun, CHEN Ang, et al. Detection of tumor cells in peripheral blood circulation in screening epithelial ovarian cancer[J]. Journal of Zhongshan University(Health Sciences), 2018, 39(6):891-896.
[18] 陈志强, 米贤军, 刘君, 等.外周血循环肿瘤细胞检测在早期子宫颈浸润癌筛查中的临床价值[J].四川大学学报(医学版), 2019, 50(3):415-419. CHEN Zhiqiang, MI Xianjun, LIU Jun, et al. Clinical value of detection of tumor cells in peripheral blood circulation in early cervical invasive cancer screening[J]. Journal of Sichuan University(Health Sciences), 2019, 50(3):415-419.
[19] 余之刚,王斐. 乳腺癌多基因检测的再思考:机遇与挑战[J].山东大学学报(医学版), 2018, 56(1):22-26, 56. YU Zhigang,WANG Fei. Rethinking of breast cancer polygene detection: opportunities and challenges [J].Journal of Shandong University(Health Sciences), 2018, 56(1):22-26, 56.
[20] Dorrigiv D, Vossoughi M, Alemzadeh I. Design and fabrication of a novel microfluidic system for enrichment of circulating tumor cells with the assistance of computer simulations[J].Avicenna J Med Biotechnol, 2019, 11(4):277-284.
[21] Kang BJ, Ra SW, Lee K, et al. Circulating tumor cell number is associated with primary tumor volume in patients with lung adenocarcinoma[J].Tuberc Respir Dis(Seoul), 2020, 83(1):61-70.
[22] Hsieh JC, Chen GY, Jhou DD, et al. The prognostic value of circulating tumor cells in Asian neuroendocrine tumors[J]. Sci Rep, 2019, 9(1):19917. doi: 10.1038/s41598-019-56539-z.
[23] Josefsson A, Larsson K, Freyhult E, et al. Gene expression alterations during development of castration-resistant prostate cancer are detected in circulating tumor cells[J]. Cancers(Basel), 2019, 12(1): pii: E39. doi: 10.3390/cancers12010039.
[24] Banys-Paluchowski M, Fehm T, Janni W, et al. Circulating and disseminated tumor cells in breast carcinoma: report from the consensus conference on tumor cell dissemination during the 39th Annual Meeting of the German Society of Senology, Berlin, 27 June 2019[J]. Geburtshilfe Frauenheilkd, 2019, 79(12):1320-1327.
[25] Tuguzbaeva G, Yue E, Chen X, et al. PEP06 polypeptide 30 is a novel cluster-dissociating agent inhibiting αv integrin/FAK/Src signaling in oral squamous cell carcinoma cells[J]. Acta Pharm Sin B, 2019, 9(6):1163-1173.
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