sICAM-1 在鉴别良、恶性乳腺病变中的临床意义。

The Clinical Significance of sICAM-1 in Differentiating Benign Breast Lesions from Breast Cancer.

机构信息

Department of Clinical Laboratory, the Sixth Medical Center of PLA General Hospital, Beijing, China

Department of Clinical Laboratory, the Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.

出版信息

Ann Clin Lab Sci. 2020 Sep;50(5):650-656.

PMID:33067211

Abstract

OBJECTIVE

Breast cancer is a common type of malignant tumour worldwide and the second leading cause of death in women. The present study aims to investigate the clinical significance of serum soluble intercellular adhesion molecule-1 (sICAM-1) in differentiating benign breast lesions from breast cancer.

METHODS

Plasma samples were obtained from 200 breast cancer patients, 47 patients with benign breast lesions and 50 age- and sex-matched healthy individuals as controls. Plasma levels of sICAM-1 were measured in all the samples using commercially available enzyme-linked immune-sorbent assay (ELISA) kits. The serum levels of carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) were detected by the UniCel® DxI 800 Immunoassay System with matched kits.

RESULTS

The plasma levels of CEA and CA15-3 were 1.22±0.2 (ng/mL) and 6.39±1.5 (ng/mL) in the healthy control group, 1.40±0.3 (ng/mL) and 5.81±2.1 (ng/mL) in the benign breast lesion (BBL) group, and 5.29±0.6 (ng/mL) and 27.08±5.7 (ng/ mL) in the breast cancer (BC) group. Plasma levels of CEA and CA15-3 in the BC group were significantly higher than those in the BBL and healthy control groups (all <0.05), but the plasma levels of CEA and CA15-3 were not significantly different between the BBL group and the healthy control group, =0.548 and =0.2976, respectively. The diagnostic sensitivity and specificity were 13.4% and 98.0% for CEA and 22.2% and 100.0% for CA15-3. For plasma sICAM-1, the diagnostic sensitivity and specificity were 98% and 94% at a cut-off value of 20.0 (ng/mL), with an area under the receiver operating characteristic (ROC) curve of 0.99, which could be used to distinguish between healthy controls and the BC group; the diagnostic sensitivity and specificity were 95.5% and 94.0% at a cut-off value of 20.0 (ng/mL) with an area under the ROC curve of 0.98, which could be used to distinguish between healthy controls and the BBL group; and the diagnostic sensitivity and specificity were 44.6% and 94.1% at a cut-off value of 40.0 (ng/mL), with an area under ROC curve of 0.68, which could be used to distinguish between the BBL group and the BC group. The plasma levels of sICAM-1 were 15.43±2.3 (ng/mL) in healthy controls, 29.8±3.5 (ng/ mL) in the BBL group, and 50.07±12.2 (ng/mL) in the BC group. The plasma level of sICAM-1 in the BC group was the highest among all three groups (all <0.05).

CONCLUSIONS

The CEA, CA15-3 and sICAM-1 levels were increased in breast cancer patients, especially in those with node and/or organ metastasis. After diagnosis, CEA, CA15-3 and sICAM-1 levels are closely related to tumour metastasis. sICAM-1 has great potential value in the clinical diagnosis of benign breast lesions and breast cancer.

摘要

目的

乳腺癌是一种常见的恶性肿瘤，也是全球女性死亡的第二大主要原因。本研究旨在探讨血清可溶性细胞间黏附分子-1（sICAM-1）在鉴别良性乳腺病变与乳腺癌中的临床意义。

方法

收集 200 例乳腺癌患者、47 例良性乳腺病变患者和 50 例年龄和性别匹配的健康个体作为对照组的血浆样本。使用商业可得的酶联免疫吸附测定（ELISA）试剂盒测量所有样本中的 sICAM-1 血浆水平。使用 UniCel®DxI 800 免疫测定系统和匹配试剂盒检测癌胚抗原（CEA）和癌抗原 15-3（CA15-3）的血清水平。

结果

健康对照组的 CEA 和 CA15-3 血清水平分别为 1.22±0.2（ng/mL）和 6.39±1.5（ng/mL），良性乳腺病变（BBL）组分别为 1.40±0.3（ng/mL）和 5.81±2.1（ng/mL），乳腺癌（BC）组分别为 5.29±0.6（ng/mL）和 27.08±5.7（ng/mL）。BC 组的 CEA 和 CA15-3 血清水平显著高于 BBL 组和健康对照组（均<0.05），但 BBL 组和健康对照组之间的 CEA 和 CA15-3 血清水平无显著差异，=0.548 和=0.2976。CEA 的诊断灵敏度和特异性分别为 13.4%和 98.0%，CA15-3 为 22.2%和 100.0%。对于 sICAM-1 血浆水平，截断值为 20.0（ng/mL）时，诊断灵敏度和特异性分别为 98%和 94%，受试者工作特征（ROC）曲线下面积为 0.99，可用于区分健康对照组和 BC 组；截断值为 20.0（ng/mL）时，诊断灵敏度和特异性分别为 95.5%和 94.0%，ROC 曲线下面积为 0.98，可用于区分健康对照组和 BBL 组；截断值为 40.0（ng/mL）时，诊断灵敏度和特异性分别为 44.6%和 94.1%，ROC 曲线下面积为 0.68，可用于区分 BBL 组和 BC 组。健康对照组的 sICAM-1 血浆水平为 15.43±2.3（ng/mL），BBL 组为 29.8±3.5（ng/mL），BC 组为 50.07±12.2（ng/mL）。BC 组的 sICAM-1 血浆水平在三组中最高（均<0.05）。