The Clinical Value Of Serum Cys-C,VEGF And CA153 In Early Diagnosis Of Breast Cancer

BackgroundBreast cancer is one of the malignant tumors that seriously endanger women's health.Patients' early symptoms are concealed,which often affects the patient's quality of life due to the delay of the disease.Therefore,it is very important for the screening of early breast cancer.At present,it mainly depends on imaging examination and pathological tissue section for diagnosis.However,due to tumor size and the traumatic effects of pathological biopsy,the shortcomings of these two methods are also very obvious,especially in the early diagnosis and tumor screening of smaller tumors.In recent years,serum breast cancer marker detection has been widely used because of its advantages such as simplicity,speed,and minimal trauma.However,single detection has limitations and it is recommended to carry out targeted joint detection.Therefore,this study investigated the clinical value of combined detection of breast cancer patients' serum Cys-C,VEGF and CA153 in the early diagnosis and screening of breast cancer.ObjectiveTo explore the clinical value of single and combined detection in early diagnosis of breast cancer by detecting the expression of serum cystatin C,vascular endothelial growth factor and CA153 in patients with early breast cancer.MethodsFrom January 2018 to January 2020,153 patients with early breast cancer(breast cancer group)and 118 patients with benign breast tumors(benign tumor group)admitted to Xinxiang Central Hospital were analyzed retrospectively,and 86 female healthy subjects(control group)who came to our hospital at the same time were collected.SerumVEGF,CA153 and Cys-C were determined by latex enhanced immunoturbidimetry,enzyme-linked immunosorbent assay(Elisa)and chemiluminescence immunoassay respectively.The difference of serum Cys-C,CA153 and VEGF levels among the three groups was compared,and the diagnostic value of three indexes in breast cancer was analyzed.Results1.The serum levels of Cys-C,CA153 and VEGF in each group were significantly higher in the breast cancer group than those in the benign tumor group and healthy examination group,and the difference was statistically significant(P<0.05).The serum levels of Cys-C,CA153 and VEGF in the breast benign tumor group were not statistically significant compared with the control group(P>0.05).2.Clinical sensitivity of serum Cys-C,CA153,VEGF was 29.41%,26.14%,49.67%;clinical specificity was 89.83%,96.61%,86.44%;positive predictive value was78.95%,90.91%,82.61%;negative predictive value was 49.53%,50.22%,56.98%;false positive rate was 10.17%,3.39%,13.56%;false negative rate was 70.59%,73.86%,50.33%;positive likelihood ratio was 2.89,7.71,3.67;the negative likelihood ratio was0.79,0.76,0.58;the Youden index was 0.192,0.228,0.361;the clinical sensitivity of serum VEGF+CA153,VEGF+Cys-C,CA153+Cys-C pairwise combination was 62.75%,64.71%,47.71%;the clinical specificity was 83.90%,77.97%,86.44%;the positive predictive value was 83.48%,79.20%,82.02%;the negative predictive value was63.46%,63.01%,56.04%;the false positive rate was 16.10%,22.03%,13.56%;the false negative rate was 37.25%,35.29%,52.29%;the positive likelihood ratio was 3.90,2.94,3.52;the negative likelihood ratio was 0.44,0.45,0.60;the Youden index was 0.467,0.427,0.342;The sensitivity of the three combined tests was 73.86%;the specificity was75.42%;the positive predictive value was 79.58%;the negative predictive value was68.99%;the false positive rate was 24.58%;the false negative rate was 26.14%;the positive likelihood ratio was 3.00;the negative likelihood ratio was 0.35;and the Youdenindex was 0.493.3.The area under the curve of serum Cys-C,CA153,VEGF in the diagnosis of early breast cancer was 0.679,0.801 and 0.777,respectively.The area under the curve of Cys-C,CA153,VEGF combined detection in the diagnosis of early breast cancer was0.875.4.There was no significant difference in serum Cys-C,CA153 expression with age,tumor size,lymph node metastasis,TNM stage,ER,PR,HER-2,Ki67 and molecular classification in breast cancer group(P > 0.05).Serum VEGF expression levels were statistically significant with lymph node metastasis,TNM stage(P<0.05),but not with age,tumor size,ER,PR,HER-2,Ki67,molecular typing(P>0.05).ConclusionThe combined detection of serum Cys-C,CA153,VEGF can improve the detection rate of early breast cancer and reduce the missed detection rate,so the combined detection of the three indexes has important clinical value in the early diagnosis of breast cancer.