Fu Shuang, Yun Zhi-Yuan, Cui Ming-Ming, Meng Hongxue, Qian Cheng, Liu Tiemin, Liu Zhi-Ping, Wang Rui-Tao, Yu Kai-Jiang
Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, China.
Department of Pathology, Harbin Medical University Cancer Hospital, Harbin 150081, China.
Oncotarget. 2017 Jun 29;8(40):67829-67836. doi: 10.18632/oncotarget.18870. eCollection 2017 Sep 15.
Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females. However, mammographic diagnosis is sometimes non-conclusive with a Breast imaging Reporting and Data System (Bi-RaDS) result of 0. Cancer antigen 15-3 (CA15-3) is the most widely used serum tumor marker for breast cancer screening. Platelet distribution width (PDW) is an early indicator of platelet activation. Fibrinogen contributed to angiogenesis and distant metastasis. The aim of this study was to investigate the ability of CA15-3, PDW, and fibrinogen individually or in combination, to distinguish breast cancer from benign breast disease. 200 consecutive patients with breast cancer and 187 patients with benign breast disease were included in this retrospective study. Patients' characteristics and hematologic tests data at initial diagnosis were collected. The benefit of adding PDW and fibrinogen to a model with only CA15-3 was evaluated as an increased in the area under the curve (AUC) obtained by receiver operating curve (ROC). CA15-3, PDW and fibrinogen are higher in breast cancer patients than in patients with benign breast disease. Single biomarkers had AUC values ranging from 0.687 for fibrinogen to 0.810 for CA15-3. In addition, the combination of PDW, CA15-3, and fibrinogen increased the AUC to 0.900 (0.866-0.928) (p<0.0001), significantly higher than those of any single marker. In conclusion, the combined use of CA15-3, PDW and fibrinogen may be clinically useful in discriminating between breast cancer and benign breast disease in non-conclusive mammography patients.
乳腺癌是女性中最常被诊断出的癌症，也是癌症死亡的主要原因。然而，乳腺钼靶诊断有时并不明确，乳腺影像报告和数据系统（Bi-RaDS）结果为0类。癌抗原15-3（CA15-3）是乳腺癌筛查中使用最广泛的血清肿瘤标志物。血小板分布宽度（PDW）是血小板活化的早期指标。纤维蛋白原促进血管生成和远处转移。本研究的目的是调查CA15-3、PDW和纤维蛋白原单独或联合使用时，区分乳腺癌和乳腺良性疾病的能力。这项回顾性研究纳入了200例连续的乳腺癌患者和187例乳腺良性疾病患者。收集了患者初诊时的特征和血液学检查数据。通过将PDW和纤维蛋白原添加到仅包含CA15-3的模型中，评估其益处，评估指标为通过受试者工作特征曲线（ROC）获得的曲线下面积（AUC）的增加。乳腺癌患者的CA15-3、PDW和纤维蛋白原水平高于乳腺良性疾病患者。单个生物标志物的AUC值范围从纤维蛋白原的0.687到CA15-3的0.810。此外，PDW、CA15-3和纤维蛋白原联合使用时，AUC增加到0.900（0.866-0.928）（p<0.0001），显著高于任何单个标志物。总之，CA15-3、PDW和纤维蛋白原联合使用在乳腺钼靶诊断不明确的患者中鉴别乳腺癌和乳腺良性疾病方面可能具有临床应用价值。
