摘要
目的观察99mTc-MDP骨扫描在乳腺癌骨转移诊断中的应用效果。方法对317例乳腺癌患者进行99mTc-MDP全身骨扫描;在99mTc-MDP全身骨扫描前1周内空腹采集患者静脉血3.0 m L,采用电化学发光法检测血清癌胚抗原(CEA)、糖链抗原125(CA125)、糖链抗原15-3(CA15-3);利用ROC曲线分析血清CEA、CA125、CA15-3与骨扫描的关系,计算CEA、CA125、CA15-3诊断乳腺癌骨转移的CUT-OFF值。结果99mTc-MDP骨扫描显示,无骨转移(阴性)者245例,有骨转移(阳性)者72例(Ⅰ级52例、Ⅱ级及以上20例)。与骨扫描阴性者比较,骨扫描Ⅰ级、Ⅱ级及以上者CEA、CA125、CA15-3水平升高(P均<0.05);与骨扫描Ⅰ级者比较,骨扫描Ⅱ级者CEA、CA125、CA15-3水平升高(P均<0.05)。99mTc-MDP骨扫描显示,在骨扫描分级达Ⅱ级及以上时,血清CEA、CA125、CA15-3的ROC曲线下面积分别为0.80、0.98、0.88,CEA、CA125、CA15-3诊断乳腺癌骨转移的CUT-OFF值分别为22.35、38.71、41.96 U/m L。结论99mTc-MDP骨扫描可作为诊断乳腺癌骨转移的筛选手段,血清CEA、CA125、CA15-3水平高于22.35、38.71、41.96 U/m L时,应高度警惕多发骨转移的发生,需行99mTc-MDP骨扫描筛查。
Objective To observe application effect of99mTc-MDP bone scanning in the diagnosis of breast cancer with bone metastasis. Methods99mTc-MDP bone scanning of the whole body was performed in 317 cases of patients with breast cancer. A week before99mTc-MDP bone scanning,fasting venous blood was collected( 3. 0 m L),and then,the serum carcinoembryonic antigen( CEA),carbohydrate antigen 125( CA125) and carbohydrate antigen 15-3( CA15-3) was detected by using the ECL assay. The relationships between serum CEA,CA125,CA15- 3 and bone scanning were analyzed by ROC curve,and we calculated CUT-OFF value of CEA,CA125,CA15-3 in diagnosis of breast cancer with bone metastasis. Results99mTc-MDP bone scanning showed there were 245 cases of patients without bone metastasis( negative),and 72 cases of bone metastasis( positive,52 cases of gradeⅠ,20 cases of grade Ⅱ and above). Compared with the negative bone scanning,the levels of CEA,CA125 and CA15-3 were increased in the patients of bone scanning gradeⅠ,Ⅱand above( all P < 0. 05);compared with gradeⅠ bone scanning,the levels of CEA,CA125 and CA15-3 were increased in patients of bone scanning gradeⅡ( all P < 0. 05).99mTc-MDP bone scanning showed when the bone scanning reached gradeⅡ and above,the area under the ROC curve of serum CEA,CA125 and CA15-3 was 0. 80,0. 98 and 0. 88,respectively. The CUT-OFF values of CEA,CA125 and CA15-3 in diagnosis of breast cancer with bone metastasis were 22. 35,38. 71 and 41. 96 U / m L. Conclusions99mTc-MDP bone scanning can be used as a diagnostic tool in the breast cancer with bone metastases screening. When the serum CEA,CA125 and CA15-3 levels are above 22. 35,38. 71 and 41. 96 U / m L,we should be more vigilant about the occurrence of multiple bone metastases,which needs for the99mTc-MDP bone scanning.
出处
《山东医药》
CAS
北大核心
2015年第11期14-17,共4页
Shandong Medical Journal
基金
中央高校基本科研业务费专项资金赞助(20620140661)
