摘要
目的 探讨酶免疫法测定乳头溢液CA1 5 - 3水平中存在的假性升高问题及其解决方法。方法 采用酶免法分别测定产妇乳汁 ,良、恶性乳头溢液经乙醚脱脂和表面活性剂TritionX - 1 0 0乳化处理前后的CA1 5 - 3浓度 ,并以处理后和处理前的乳头溢液CA1 5 - 3浓度的比值作为指标。评估其在筛查良恶性乳头溢液中的应用价值。结果 经乙醚和Tri tionX - 1 0 0处理后 ,产妇乳汁和良恶、性乳头溢液CA1 5 - 3的测定值均呈现显著下降 (P <0 .0 1 ) ,良性乳头溢液CA1 5 - 3下降幅度较大 ,其处理后 /前CA1 5 - 3比值为 0 .550 34± 0 .1 0 82 3(x±s) ,而恶性乳头溢液CA1 5 - 3则下降幅度较小 ,处理后 /前CA1 5 - 3比值为 0 .82 578± 0 .0 5781 ,两比值间有显著性差异 (P <0 .0 1 ) ,以良性溢液组比值的均值加上 2倍的标准差即 0 .76680作为乳腺恶性肿瘤诊断的阳性界值 ,则其敏感性为 81 .2 5 % (1 3/1 6) ,特异性为 96 .97% (32 /33) ,阳性预期值为92 .86 % (1 3/1 4 ) ,阴性预期值为 91 .43 % (32 /35)。结论 采用乙醚脱脂和表面活性剂TritionX - 1 0 0乳化处理乳头溢液 ,可明显减少乳头溢液CA1 5 - 3酶免法测定中存在的假性升高问题。处理后 /前乳头溢液CA1 5 - 3比值可用于良、恶性乳头溢液的筛查试验。
Objective To investigate the falsc positive problem of determining CA15-3 in breast secretion and its improved methods.Methods The CA15-3 levels in breast secretions were detected respectively from 13 obstetric patients, 33 patients with benign breast disease, 16 patients with breast cancer by immunoenzymatic assay. Before and after the secretions were processcd with ether and surfactant Triton X-100. The CA15-3 ratio of process-previous to process-postcrior were also calculated to be applied in secreening of benign or malignant breast secretions.Results After processcd by ether and surfactant Triton X-100, the CA15-3 of all breast secretions decreased significantly in different degree(P<0.01). The secretion CA15-3 ratio (post/pre) were 0.55034±0.10823 (x±s) for breast benign secretion and 0.82578±0.05781 (x±s) for breast malignant secrction respectively. There were significant difference between them.(P<0.01). When the mean seeretion CA15-3 ratio of breast benign discase group added to two times of its standard deviation(s) was used as the positive cutoff value for the diagnosis of breast cancer, the sensitivity was 81.25%(13/16), and the speciality was 96.97%(32/33); The prognostic positive and negative rates were 92.86%(13/14) and 91.43%(32/35)respectively.Conclusions The false riscs problem in determination of breast secretion CA15-3 can be decreased by means of degreasing with ether and emulsification with surfactant Triton X-100. The secretion CA15-3 ratio of process-previous to process-posterior is of valuable in secreening of breast benign and malignant secretion.
出处
《江西医学检验》
2004年第2期105-107,共3页
Jiangxi Journal of Medical Laboratory Sciences
基金
江西省卫生厅资助项目
