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目的探讨联合应用全身骨显像及肿瘤标志物对乳腺癌骨转移诊断中的临床价值。方法回顾性分析对150例确诊乳腺癌患者的全身骨显像及肿瘤标志物[糖链抗原153(CA15-3)、癌胚抗原(CEA)及糖链抗原125(CA-125)]检测结果的资料。结果 150例乳腺癌患者中确诊为骨转移的是86例,骨显像诊断骨转移的灵敏度为91.86%,特异性为76.56%,准确性为85.33%,阳性预测值为84.04%,阴性预测值为87.50%。乳腺癌骨转移组血清CA15-3、CEA、CA-125水平高于未发生骨转移组,差异有统计学意义(P<0.05)。血清CA15-3、CEA及CA-125含量升高与乳腺癌骨转移分级呈正相关(P值均<0.05)。联合应用全身骨显像及检测肿瘤标志物CA15-3、CEA及CA-125诊断乳腺癌骨转移的灵敏度为95.71%,特异性为87.69%,准确性为94.36%,阳性预测值为87.56%,阴性预测值为92.22%。结论联合应用全身骨显像及检测肿瘤标志物CA15-3、CEA及CA-125诊断的乳腺癌骨转移的灵敏性、特异性及准确性高,为乳腺癌骨转移早期诊断、治疗方案的选择、预后判断提供可靠依据。
Objective To investigate the clinical value of combined application of whole body bone imaging and tumor markers in the diagnosis of breast cancer with bone metastasis. Methods We retrospectively analyzed the results of whole body bone imaging and tumor markers (CA15-3, CEA and CA125) in 150 patients with confirmed breast cancer. data of. Results The bone metastasis was diagnosed in 150 cases of breast cancer in 86 cases. The sensitivity of bone imaging in diagnosis of bone metastasis was 91.86%, specificity was 76.56%, accuracy was 85.33%, positive predictive value was 84.04%, negative predictive value 87.50%. The serum levels of CA15-3, CEA and CA-125 in breast cancer patients with bone metastasis were significantly higher than those without bone metastasis (P <0.05). Serum levels of CA15-3, CEA and CA-125 were positively correlated with bone metastasis and grading of breast cancer (all P <0.05). The sensitivity of combined application of whole body bone imaging and detection of tumor markers CA15-3, CEA and CA-125 in the diagnosis of breast cancer bone metastasis was 95.71%, specificity was 87.69%, accuracy was 94.36%, positive predictive value was 87.56% The negative predictive value was 92.22%. Conclusions The sensitivity, specificity and accuracy of combined application of whole body bone imaging and detection of tumor markers CA15-3, CEA and CA-125 in the diagnosis of breast cancer bone metastasis are high, which are the early diagnosis and treatment options for breast cancer with bone metastasis Prognosis to provide a reliable basis.