摘要目的 探讨乳头溢液及血清肿瘤标记物癌胚抗原(CEA)、恶性肿瘤特异性生长因子(TSGF)、骨桥蛋白(OPN)、糖类抗原(CA125)联合检测诊断乳腺癌及增生性病变的临床应用价值.方法 应用电化学发光法检测122例乳腺疾病(乳腺癌组21例、乳腺癌前病变组101例)乳头溢液和血清CEA、TSGF、OPN及CA125水平,另选30例哺乳期妇女作为健康对照组,分析乳头溢液及血清肿瘤标记物水平与乳腺良恶性疾病的关系.结果 乳腺癌患者乳头溢液及血清CEA、TSGF、OPN及CA125水平显著高于良性病变组和正常对照组(P＜0.01),且乳腺癌患者乳头溢液四种标志物水平显著高于自身血清水平(P＜0.01);乳头溢液及血清四种标志物联合检测可显著提高乳腺癌的诊断敏感性达95.24％.结论 乳头溢液中CEA、TSGF、OPN及CA125水平高于血清,肿瘤早期未侵犯基底膜未进入血液前,血液中CEA、TSGF、OPN及CA125水平变化不大,而此时作为肿瘤“浸泡液”的乳头溢液中已溶解有大量的CEA、TSGF、OPN及CA125;乳头溢液与血清联合检测可相互补充、相互印证,提高乳腺癌诊断的敏感性,减少漏诊,对乳腺癌早期诊断有帮助.

abstractsObjective To investigate the clinical value of combined detection of CEA,TSGF,OPN and CA125 both in nipple discharge and serum for the diagnosis of breast cancer and intraductal proliferative lesions.Methods The serum and nipple discharge of 122 patients(21 cases of breast cancer and 101 cases of benign lesions) was collected and the tumor markers of CEA,TSGF,OPN and CA125 were detected by electrochemiluminescence method,and those were compared with those of 30 healthy pregnant women.And the relationship between nipple discharge and serum tumor markers and breast benign and malignant disease was analyzed.Results The nipple discharge and serum levels of CEA,TSGF,OPN and CA125 in bresat cancer patients were significantly higher than those in the patients with benign breast disease and those in normal pregnant women(P ＜0.01).The levels of CA153,TSGF,CA125 and CEA in nipple discharge were significantly higher than in those in the serum(P ＜0.01).The sensitivity of the dyn amic combined detection of the four tumor markes in nipple discharge and serum was 95.24％.ConcluSions The levels of CEA,TSGF,OPN and CA125 in nipple discharge were significantly higher than those in the serum.The dynamic combined detection of the four tumor markers both in nipple discharge and serum are benefit for early diagnosis and interference and better prewarning markers for monitoring the recurrence and metastasis of breast cancer.