Predictive Analysis Of Multiple Tumor Markers In The Diagnosis Of Metastatic Breast Cancer

Background:According to the global cancer statistics of The International Agency for Research on Cancer(IARC)in 2018,Breast cancer is the highest incidence rate and mortality rate in women.30% of the patients with early breast cancer who have been treated actively will still develop into metastatic breast cancer(MBC).When breast cancer patients advanced to the late stage,especially after metastasis,the 5-year survival rate was significantly reduced,and the prognosis was poor,which was the main cause of death.Therefore,it is very important to find breast cancer metastasis as early as possible and improve the prognosis of patients.Tumor marker(TM)is simple,fast,economical,easy to detect,repeatable,and dynamic monitoring of therapeutic effect,which makes it still irreplaceable in the new detection methods.However,the main reason for limiting TM application in malignant tumors is low sensitivity.Many experiments at home and abroad have proved that joint detection is one of the effective ways to improve TM sensitivity.Therefore,it is of positive practical significance to study the diagnostic value of TM in metastatic breast cancer.Purpose:To investigate the predictive value of single or combined detection of carcinoembryonic antigen(CEA),carbohydrate antigen153(CA153),carbohydrite antigen 125(CA125),and carbohydra antigen 199(CA199)in diagnosis of metastatic breast cancer.Method:The clinical data of 180 metastatic breast cancer patients and 170 cases of breast cancer without metastasis were collected from January 2011 to December 2019 in the second hospital of Jilin University.Metastatic breast cancer was defined as metastatic breast cancer group,and non metastatic breast cancer was defined as control group.The results of CEA,CA125,CA153,and CA199 were collected by the day of admission or outpatient.The range above the reference value is defined as positive.When the multiple tumor markers(TM)were tested together,at least one TM positive was defined as positive.The data of the two groups were collected and SPSS 20.0 was used to make statistics.P ＜ 0.05,the difference was statistically significant.Result:1.The levels and positive rates of CA153,CA125,CEA and CA199 in metastasis breast cancer group were significantly higher than those in the non metastasis breast cancer group(P ＜ 0.05).2.The sensitivity of CA153(48.33%)and CEA(47.22%)was the highest in the diagnosis of MBC.There was significant difference between CA153 and CEA in the sensitivity of CA199 and CA125,P ＜ 0.05.There was no significant difference in sensitivity between CA153 and CEA(P ＞ 0.05).There was no significant difference in the specificity among the four TM,P ＞ 0.05.3.The sensitivity of the four tumor markers combined group,three tumor markers combined group and two tumor markers combined group were significantly higher than that of single tumor marker,P ＜ 0.05.The specificity of the combined tumor marker groups was lower than that of single tumor marker group(P ＞ 0.05).4.The sensitivity of the two tumor markers combined group was significantly higher than that of single tumor marker group(P ＜ 0.05).The sensitivity of the three tumor markers combined group was significantly higher than that of the two tumor markers combined group(P ＜ 0.05).There was no significant difference in sensitivity between the four tumor markers combined group and the three tumor markers combined group(P ＞ 0.05).5.According to receiver operating characteristic curve(ROC),the single TM with the largest area under the curve(AUC)was CEA,AUC was 0.709,P ＜ 0.001,followed by CA153,AUC was 0.693,P ＜ 0.001.6.According to the ROC curve,the combination with the largest area under the curve(AUC)is the combination with the greatest predictive diagnostic value of MBC.The results showed that CEA+CA153+CA125 was the most valuable combination in the predictive diagnosis of MBC,AUC was 0.778,P ＜ 0.001.Conclusion1.CEA and CA153 had the highest sensitivity in predicting MBC with single TM.2.The sensitivity of combined TM was significantly better than that of single TM.The more TM combined items,the higher the sensitivity,but the lower the specificity.3.ROC curve results showed that CEA was the most valuable in predictive diagnosing MBC with single TM.4.The combination of CEA+CA153+CA125 is the most valuable in the predictive diagnosis of MBC.