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背景与目的:Ⅰ型胶原羧基端肽(carboxyterminal telopeptide of typeⅠcollagen,ICTP)为骨吸收标志物,糖类抗原15-3(carbohydrate antigen 15-3,CA15-3)属于肿瘤相关性抗原。本研究通过对乳腺癌术后患者ICTP与CA15-3水平的定期检测,并随访观察,探讨ICTP与CA15-3水平与乳腺癌骨转移发生率的相关性。方法:对61例乳腺癌术后患者定期检测血清ICTP与CA15-3水平,术后第1年每个月检测1次,第2年每2个月1次,第3年每3个月1次。观察临床分期与血清ICTP与CA15-3阳性率的关系,评估联合检测血清ICTP、CA15-3对乳腺癌骨转移的诊断价值。结果:临床分期Ⅰ、Ⅱ期ICTP与CA15-3阳性升高率低,Ⅲ、Ⅳ期阳性升高率明显增高,各分期比较差异有统计学意义(P<0.05)。随着血清ICTP、CA15-3水平升高,各个区段骨转移发生率之间差异有统计学意义(P<0.01);两者均与骨转移发生有良好相关性(P<0.01),且两者之间呈中度相关。61例中有27例ICTP、CA15-3均升高并呈阳性,其中有21例出现临床骨转移症状,占77.78%;在11例ICTP与CA15-3均为阴性的术后患者中,有1例出现临床骨转移症状及相关证据,占9.01%;两者相比差异有统计学意义(P<0.01)。ICTP与CA15-3联合检测对乳腺癌骨转移诊断的敏感性、特异性及阳性预测值、阴性预测值均高于单独检测。结论:定期检测乳腺癌术后患者血清ICTP与CA15-3,对预测骨转移有重要的临床应用价值。
BACKGROUND & OBJECTIVE: The carboxyterminal telopeptide of typeⅠcollagen (ICTP) is a marker of bone resorption. Carbohydrate antigen 15-3 (CA15-3) is a tumor-associated antigen. In this study, we examined the levels of ICTP and CA15-3 in postoperative patients with breast cancer and observed the correlation between the levels of ICTP and CA15-3 and the incidence of bone metastases in breast cancer. Methods: Serum levels of ICTP and CA15-3 were measured in 61 patients with postoperative breast cancer. The patients were tested once a month for the first year after operation, once every two months for the second year, every three months for the third year Times. The relationship between clinical stage and serum ICTP and CA15-3 positive rate was observed, and the diagnostic value of combined detection of serum ICTP and CA15-3 in breast cancer with bone metastasis was evaluated. Results: The positive rates of ICTP and CA15-3 in clinical staging Ⅰ and Ⅱ were low, and the positive rates in stage Ⅲ and Ⅳ were significantly increased (P <0.05). With the increase of serum ICTP and CA15-3 levels, there was a significant difference in the incidence of bone metastases between the two groups (P <0.01). Both of them had a good correlation with bone metastasis (P <0.01) There was a moderate correlation between the two. Among the 61 cases, 27 cases were positive for ICTP and CA15-3, of which 21 cases had clinical bone metastasis, accounting for 77.78%. Of 11 postoperative patients with negative ICTP and CA15-3, One case had clinical bone metastasis symptoms and related evidence, accounting for 9.01%; the difference between the two groups was statistically significant (P <0.01). The sensitivity, specificity, positive predictive value and negative predictive value of combined detection of ICTP and CA15-3 in the diagnosis of breast cancer with bone metastases were higher than those of single tests. Conclusion: Regular detection of serum ICTP and CA15-3 in postoperative patients with breast cancer has important clinical value in predicting bone metastasis.