彩色多普勒超声联合血清CEA、CA125、TK1、TFF1对乳腺癌的诊断价值研究

摘要 目的：探究彩色多普勒超声联合血清癌胚抗原（CEA）、糖类抗原125（CA125）、胸苷激酶1（TK1）、三叶因子1（TFF1）对乳腺癌的诊断价值。方法：回顾性选取2019年1月到2022年1月间我院收治的97例乳腺癌患者为观察组，同期收治的97例乳腺良性病变患者为对照组，均行彩色多普勒超声检查及血清CEA、CA125、TK1、TFF1检测，比较两组超声特征、超声参数搏动指数（PI）、收缩期峰值流速（PSV）、阻力指数（RI）]，比较两组血清CEA、CA125、TK1、TFF1水平，通过受试者工作特征（ROC）曲线分析彩色多普勒超声联合血清CEA、CA125、TK1、TFF1诊断价值及单独诊断价值。结果：与对照组比较，观察组肿块边界不清晰、内部回声不均匀、形态不规则和钙化比例明显升高（P＜0.05）。与对照组比较，观察组患者RI、PSV、PI明显升高（P＜0.05）；其中观察组血流信号分级Ⅲ级比例明显高于对照组（P＜0.05），观察组血流信号分级0级比例明显低于对照组（P＜0.05）。与对照组比较，观察组患者血清CEA、CA125、TK1、TFF1水平明显升高（P＜0.05）。ROC曲线发现，超声诊断乳腺癌的曲线下面积（AUC）值、灵敏度、特异度依次为0.773、76.30%、78.40%。CEA诊断乳腺癌的AUC值、灵敏度、特异度依次为0.774、78.40%、74.23%。CA125诊断乳腺癌的AUC值、灵敏度、特异度依次为0.824、77.31%、80.41%。TK1诊断乳腺癌的AUC值、灵敏度、特异度依次为0.818、78.43%、81.42%。TFF1诊断乳腺癌的AUC值、灵敏度、特异度依次为0.806、78.42%、77.31%。彩色多普勒超声联合血清CEA、CA125、TK1、TFF1诊断乳腺癌的AUC值0.929，显著优于各项指标单独使用（P＜0.05）。结论：与各项指标单一应用相比，彩色多普勒超声联合血清CEA、CA125、TK1、TFF1诊断乳腺癌的价值较高，有助于乳腺癌的早期筛查。

Diagnostic Value of Color Doppler Ultrasound Combined with Serum CEA, CA125, TK1 and TFF1 in Breast Cancer

ABSTRACT Objective: To explore the diagnostic value of color Doppler ultrasound combined with serum carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), thymidine kinase 1 (TK1) and trefoil factor 1 (TFF1) in breast cancer. Methods: 97 patients with breast cancer who were admitted to our hospital from January 2019 to January 2022 were retrospectively selected as the observation group, and 97 patients with benign breast lesions who were admitted during the same period were selected as the control group. All patients underwent color Doppler ultrasonography and serum CEA, CA125, TK1 and TFF1 detection. Ultrasonic characteristics and ultrasonic parameters pulsatility index (PI), peak systolic velocity (PSV), resistance index (RI)] were compared in the two groups. Serum CEA, CA125, TK1 and TFF1 levels were compared in the two groups. The diagnostic value of color Doppler ultrasound combined with serum CEA, CA125, TK1 and TFF1 and its diagnostic value alone were analyzed by receiver operating characteristic(ROC) curve. Results: Compared with the control group, the unclear mass boundary, uneven internal echo, irregular shape and calcification ratio in the observation group were significantly increased(P<0.05). Compared with the control group, RI, PSV and PI in the observation group were significantly higher(P<0.05). The proportion of blood flow signal grade III in the observation group was significantly higher than that in the control group(P<0.05), and the proportion of blood flow signal grade 0 in the observation group was significantly lower than that in the control group(P<0.05). Compared with the control group, the serum CEA, CA125, TK1, TFF1 levels in the observation group were significantly higher (P<0.05). ROC curve found that the area under the curve (AUC) value, sensitivity and specificity of ultrasound diagnosis of breast cancer were 0.773, 76.30% and 78.40% respectively. The AUC value, sensitivity and specificity of CEA in the diagnosis of breast cancer were 0.774, 78.40% and 74.23% respectively. The AUC value, sensitivity and specificity of CA125 in diagnosing breast cancer were 0.824, 77.31% and 80.41% respectively. The AUC value, sensitivity and specificity of TK1 in diagnosing breast cancer were 0.818, 78.43% and 81.42% respectively. The AUC value, sensitivity and specificity of TFF1 in diagnosing breast cancer were 0.806, 78.42% and 77.31% respectively. The AUC value of color Doppler ultrasound combined with serum CEA, CA125, TK1, TFF1 in the diagnosis of breast cancer was 0.929, which was significantly better than that of each indicator used alone (P<0.05). Conclusion: Compared with the single application of various indicators, color Doppler ultrasound combined with serum CEA, CA125, TK1, TFF1 has a higher value in the diagnosis of breast cancer, which is helpful for the early screening of breast cancer.