目的 探讨Ⅰ型胶原吡啶交联终肽(ICTP)、血清抗酒石酸盐酸性磷酸酶 5b(Tracp 5b)联合 CA15-3 检测在乳腺癌 骨转移中的诊断价值。 方法 采用回顾性研究,收集 2009 年 9 月至 2012 年 8 月于首都医科大学附属北京世纪坛医院乳腺科就 诊的女性乳腺癌患者 87 例,根据骨转移情况分为骨转移组 32 例,无转移组 35 例,骨外转移组 20 例。 并取同期收治的乳腺良 性肿瘤患者 25 例为良性对照组应用酶联免疫吸附试验(ELISA)或化学发光免疫分析(CLISA)方法检测 87 例乳腺癌患者以及 25 例良性对照组患者的血清 ICTP、Tracp 5b 及 CA15-3 水平。 结果 血清 ICTP、Tracp 5b 和 CA15-3 水平在骨转移组显著升高 (P<0. 05)。 ICTP、Tracp 5b、CA15-3 平行联合检测诊断乳腺癌骨转移的敏感性、特异性、阳性预测值及阴性预测值分别为 96. 88%、76. 36%、70. 45%、97. 67%。 平行联合检测的敏感性较 ICTP、Tracp 5b、CA15-3 单独检测时显著提高,差异有统计学 意义(P<0. 05)。 ICTP、Tracp 5b、CA15-3 三项指标系列联合检测诊断乳腺癌骨转移的敏感性、特异性、阳性预测值及阴性预 测值分别为 37. 50%、98. 18%、92. 31%、72. 97%,系列联合检测的特异性较各指标单独检测时显著提高,差异有统计学意义 (P<0. 05)。 联合诊断较三者独立诊断的效能高。 结论 血清 ICTP、Tracp 5b 联合 CA15-3 检测可显著提高乳腺癌骨转移的诊断效率,可作为辅助影像学诊断乳腺癌骨转移的有效实验室指标。

Objective To explore the diagnostic value of ICTP Tracp 5b and CA15-3 in bone metastasis of breast cancer. Method A retrospective review was performed in 87 breast cancer and 25 breast benign diseases the breast cancer patients were divided into 3 groups 32 patients with bone metastasis 35 patients with no metastasis and 20 patients with extraosseous metastasis. The serum levels of serum ICTP Tracp 5b and CA15 - 3 in 87 patients with breast cancer and 25 patients with benign tumor were measured by enzyme-linked immunosorbent assay ELISA and chemiluminescence immunoassay CLISA . Result The serum levels of ICTP Tracp 5b and CA15-3 were significantly increased in the bone metastasis group P < 0. 05 . The sensitivity specificity positive predictive value and negative predictive value of the parallel combined detection of serum ICTP Tracp 5b and CA15-3 in the diagnosis of bone metastasis of breast cancer were 96. 88% 76. 36% 70. 45% and 97. 67% respectively. The sensitivity of parallel combined detection is significantly greater than ICTP Tracp 5b and CA15-3 P<0. 05 . The sensitivity specificity positive predictive value and negative predictive value of the parallel combined detection were 37. 50% 98. 18% 92. 31% and 72. 97% respectively. The specificity of parallel combined detection is significantly greater than ICTP Tracp 5b and CA15-3 P<0. 05 . Joint diagnosis is more effective than independent diagnosis of the three. Conclusion The detection of serum ICTP Tracp 5b and CA15-3 can significantly improve the diagnostic efficiency of bone metastasis in breast cancer and can be used as an effective laboratory index to assist imaging diagnosis of bone metastasis in breast cancer.