Value Of Serum Tumor Markers CA15-3,VEGF And Ultrasound BI-RADS Classification For Diagnosis Of Breast Cancer

Objective:Explore and analyze the value of serum tumor markers Cancer Antigen 15-3(CA15-3),Vascular Endothelial Growth Factor(VEGF)and Breast Imaging Reporting and Data System(BI-RADS)classification for the diagnosis of breast cancer,providing clinicians with a scientific basis for early diagnosis of breast cancer.Methods:Collect clinical data of 160 patients with benign tumors and 100 patients with malignant tumors pathologically confirmed in the Second Hospital of Shanxi Medical University from April 2018 to January 2020 and conduct retrospective studies.Collect serum CA15-3 and VEGF concentrations before surgery as well as preoperative breast ultrasound data,CA15-3 was detected by electrochemical luminescence,and VEGF was detected by enzyme linked immunosorbent assay.Breast ultrasonography is performed by1-2 experienced ultrasound doctors,and each patient is graded by BI-RADS.Use Wilcoxon test,Chi-square test,Spearman correlation analysis and draw ROC(Receiver Operating Characteristic,ROC)curve and calculate the area under the ROC curve(Area Under Curve,AUC),Youden index and the best cutoff value.Individual and/or combined comparison and analysis the value of serum CA15-3,VEGF and patient's ultrasound BI-RADS classification for the diagnosis of breast cancer.Results:(1)Serum CA15-3(M=8.54)and ultrasound BI-RADS classification(M=5)in breast cancer group were higher than CA15-3(M=5.74)and ultrasound BI-RADS classification(M=3)of the benign group.The level of VEGF(M=85.5)in breast cancer group was slightly lower than that of the benign group(M=86.0).There were statistical significances of differences in serum CA15-3(Z=-4.861,P=0.000)and ultrasound BI-RADS classification(Z=-12.121,P=0.000)between the two groups.There was no statistical significance of difference in serum VEGF(Z=-0.449,P=0.653)between the two groups.(2)The sensitivities of serum CA15-3(c~2=9.517,P=0.002),VEGF(c~2=0.018,P=0.894)and ultrasound BI-RADS classification(c~2=101.691,P=0.000)were separately detected:9%,27%,and 94%,with specificities of 99.4%,73.8%,and 70%,and accuracy of 64.6%,55.8%,and 79.2%,respectively.(3)Combined analysis,the combination of VEGF and ultrasound(c~2=66.963,P=0.000)has the highest sensitivity(95%);the combination of CA15-3 and VEGF(c~2=1.116,P=0.291)has the highest specificity(73.1%);the combination of CA15-3 and ultrasound(c~2=101.691,P=0.000)has the highest diagnostic accuracy(79.2%).The results of the combined analysis of the three(c~2=66.963,P=0.000)and the combined results of VEGF and ultrasound were completely consistent,and both reached the highest sensitivity(95%)while the specificity was reduced to the lowest(55%).(4)Except VEGF,the correlation analysis between CA15-3 and ultrasound and pathological stage was statistically significant(P<0.05).Among the analysis results of the correlation between the three and axillary lymphatic metastasis,only the ultrasound BI-RADS classification had significant statistical significance(P<0.001).The results of the correlation analysis between these three and age were not statistically significant regardless of benign and malignant(P>0.05).(5)The areas under curve of serum CA15-3,VEGF and ultrasound BI-RADS classification were0.679,0.483 and 0.921,and the best cutoff values were 8.23 U/ml,168 ng/ml and4a.The AUC of the combination of CA15-3 and VEGF,the combination of VEGF and ultrasound,the combination of CA15-3 and ultrasound,and the combination of the three are:0.689,0.929,0.936 and 0.935.Conclusion:1.Serum CA15-3 has a high value for the diagnosis of breast cancer,and better able to exclude the diagnosis of breast cancer.The serum CA15-3 concentration will increase with the increase of clinical pathological stage.2.Serum VEGF alone has little application value in both diagnosis and exclusion of breast cancer.However,VEGF and ultrasound BI-RADS classification used in conjunction able to greatly enhance the diagnostic sensitivity.3.Ultrasound BI-RADS classification is the most valuable of the three methods for diagnosing breast cancer,and its diagnostic significance will continue to increase with the increase of clinical pathological stage and axillary lymph node metastasis.