Effect of ultrasonic elastography combined with serum carbohydrate antigen 15-3, C keratin 19 fragment antigen 21-1 and prostate specific antigen levels detection on the sensitivity and accuracy of breast cancer diagonsis

Abstract

Objective To investigate the effect of ultrasound elastography combined with serum carbohydrate antigen 15-3 (CA15-3 C), C keratin 19 fragment antigen 21-1 (CYFRA21-1) and prostate specific antigen (PSA) levels detection on the sensitivity and accuracy of breast cancer diagnosis. Methods Sixty cases of breast cancer from December 2015 to January 2017 were selected as study group, and all cases were diagnosed as breast cancer by pathological examination. They were divided into groups according to the TNM classification criteria of breast cancer, stage Ⅰ22 cases, stageⅡ17 cases, stage Ⅲ 14 cases, stage Ⅳ7 cases. Fifty-three cases of benign breast diseases were selected as control group. The levels of serum CA15-3, CYFRA21-1 and PSA were compared among two groups and the study group at different stages. The correlations between serums CA15-3, CYFRA21-1 and PSA expression level and breast cancer staging were analyzed. The results of pathological examination were regarded as gold standard. Serum CA15-3, CYFRA21-1, PSA levels, single detection of ultrasound elastography and combined detection of breast cancer results were compared. Results The levels of serum CA15-3, CYFRA21-1 and PSA in study group were higher than those in control group: (37.98 ± 4.71) kU/L vs. (8.58 ± 3.04) kU/L, (5.41 ± 3.24) μg/L vs. (1.42 ± 0.47) μg/L, (0.39 ± 0.11) μg/L vs. (0.16 ± 0.04) μg/L, and there were significant differences (P<0.01). The levels of serum CA15-3, CYFRA21-1 and PSA in patients with stage Ⅲ and Ⅳof breast cancer were higher than those of patients with stageⅠandⅡof breast cancer, and there were significant difference (P<0.01). Spearman correlation analysis showed that serum CA15-3, CYFRA21-1 expression levels and breast cancer staging was positively correlated (P < 0.05). There was a negative correlation between serum PSA expression and breast cancer staging (P < 0.05). The sensitivity 98.33%(59/60), specificity 96.23%(51/53) and accuracy rate 97.35%(110/113) of breast cancer detected by serum CA15-3, CYFRA21-1, PSA levels and ultrasonic elastography was higher than that of single dectction, and the difference was statistically significant (P < 0.05). Conclusions The levels of serum CA15-3, CYFRA21-1 and PSA are closely related to the occurrence and progression of breast cancer. The combination of serum CA15-3, CYFRA21-1 and PSA levels with ultrasonic elastography can improve the specificity, sensitivity and accuracy of diagnosis of breast cancer. Key words: Breast neoplasm; Ultrasound elastography; Mucin-1; C keratin 19 fragment antigen 21-1; Prostate specific antigen