Diagnostic Value of the Combined Test of Serum CA153, CA125 and CEA in Detection of Breast Cancer: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 YAOLi-yun ,  SHIGen-lin

Department of Laboratory, Jiangsu Provincial Corps Hospital, Yangzhou 225003, China;

Corresponding author：

SHIGen-lin, Email: 2364613601@qq.com

Keywords：

Breast cancer; CA153; CA125; CEA; Systematic review; Meta-analysis; Diagnostic test

DOI：

10.7507/1672-2531.20150011

Video：

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Objective To systematically review the diagnostic value of the combined test of serum CA153, CA125 and CEA in detection of breast cancer. Methods Clinical diagnostic tests about CA153, CA125 and CEA in patients with breast cancer were retrieved in PubMed, EMbase, CBM, The Cochrane Library (Issue 3, 2014), CNKI, VIP, and WanFang Data from January 1st, 2004 to April 16st, 2014. References of included literature were also retrieved. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment were completed by two reviewers independently. Meta-analysis was then conducted using Meta-Disc 1.4 software. Results A total of 21 studies involving 4 263 subjects were enrolled. In all studies, the results of meta-analysis indicated that:the DOR, AUC and Q index of the single test (CA153) were 18.71 (95%CI 11.62 to 30.11), 0.858 9, and 0.789 7; while those of the combined test (CA153, CA125 and CEA) were 37.95 (95%CI 21.97 to 65.57), 0.959 1, 0.903 1. Compared with the single test, the diagnostic efficacy of the combined test was higher (Z=3.675, P=0.001 5). Conclusion Compared with the detection of CA153 alone, the combined detection of CA125, CA153 and CEA has higher efficacy and accuracy in the diagnosis of breast cancer.

Citation： YAOLi-yun, SHIGen-lin. Diagnostic Value of the Combined Test of Serum CA153, CA125 and CEA in Detection of Breast Cancer: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(1): 54-61. doi: 10.7507/1672-2531.20150011 Copy

1.	Jemal A, Siegel R, Xu JC, et al. Cancer statistics. CA, 2010, 60(5):277-300.
2.	Anderson BO, Shyyan R, Eniu A, et al. Breast cancer in limited-resource countries:an overview of the Breast Health Global Initiative 2005 guidelines. Breast J, 2006, 12(Suppl 1):3-15.
3.	贺延莉, 靳二虎. 乳腺癌的影像学诊断进展. 国际医学放射学杂志, 2008, 31(4):235-239.
4.	张嘉庆, 王殊, 乔新民. 乳腺癌的现状和远景. 中华外科杂志, 2002, 40 (3):161-163.
5.	Park BW, Oh JW, Kim JH, et al. Preoperative CA153 and CEA serum levels as predictor for breast cancer outcomes. Ann Oncol, 2008, 19(4):675-681.
6.	Geng B, Liang MM, Ye XB, et al. Association of CA 15-3 and CEA with clinicopathological parameters in patients with metastatic breast cancer. Mol Clin Oncol, 2015, 3(1):232-236.
7.	Gao J, Zhang Q, Xu J, et al. Clinical significance of serum miR-21 in breast cancer compared with CA153 and CEA. Chin J Cancer Res, 2013, 25(6):743-748.
8.	易琳, 刘兴明, 林丁, 等. 血清CAl53、CAl25、CEA联合检测在乳腺癌诊断中的价值. 重庆医科大学学报, 2012, 37(9):802-805.
9.	张木坤, 刘露, 黄仁青, 等. 血清CAl53、CAl25和CEA联合检测在乳腺癌临床诊疗中的应用. 国际医药卫生导报, 2012,18(9):1321-1323.
10.	王景萍, 洪锡田, 盛家和. 联合检测血清糖类抗原153、糖类抗原125、癌胚抗原在乳腺癌中的诊断价值探讨. 河南医学研究, 2007, 16(3):243-245.
11.	陈军. CAl53、CAl25、CEA联合检测在乳腺癌的临床应用. 临床和实验医学杂志, 2007, 6(10):94-95.
12.	张敏, 景永. 三种肿瘤标志物联合检测在乳腺癌诊断中的临床价值. 中国现代药物应用, 2010, 4(14):48-49.
13.	韩媛媛, 李新杰, 王萍, 等. 3项肿瘤标志物检测对乳腺癌的诊断价值. 检验医学与临床, 2012, 9(22):2859-2860.
14.	陈艺文. CAl53、CAl25及CEA联合检测对乳腺癌诊断的意义. 农垦医学, 2012, 34(5):401-403.
15.	田雪玲, 秦林其, 王艳敏. 血清CA125, CA153, CEA联合检测在乳腺癌诊断的意义. 中国实用医药, 2012, (6):87-88.
16.	陈秋芸. CA125、CA153、CEA联合检测在乳腺癌诊断中的临床意义. 中国医药指南, 2011, 9(27):70-71.
17.	邱厚匡, 张智, 张珍, 等. 多种肿瘤标志物联合检测对乳腺癌诊断的临床意义. 临床医学工程, 2011, 18(6):860-861.
18.	钱海英. 肿瘤标志物CAl53、CAl25、CEA联合检测在乳腺癌中的临床应用. 医学检验与临床, 2008, 19(2):32-33.
19.	左新华, 周斌. CAl53、CAl25、CEA联合检测在乳腺癌诊断中的应用价值. 中国医药科学, 2011, 1(10):135-136.
20.	范柳笛. CA153、CEA、CA125 联合检测对乳腺癌诊断的意义研究. 临床医学, 2013, 26(16):102-103.
21.	练治平. CA153、CEA及CA125联合检测对乳腺癌诊断的意义. 国际医药卫生导报, 2012, 18(18):2753-2755.
22.	陈光意, 苏金明, 吕晓娴. CEA、CA153及CA125对乳腺癌的诊断. 中国误诊学杂志, 2005, 5(5):871-872.
23.	叶蓓, 柳光宇, 陆劲松, 等. 常用的乳腺癌血清肿瘤标志物在早期诊断中的应用价值不高. 中国癌症杂志, 2009, 19(10):807-808.
24.	陈士华. 联合检测CA153、CA125、CEA对乳腺癌的临床价值探讨. 检验医学, 2013, 28(3):235-237.
25.	吴爱祝, 蔡俊宏, 梁茱, 等. 血清CEA、CA125、CA153联合检测在乳腺癌诊断中的应用. 山东医药, 2011, 51(30):94-95.
26.	吕蕾, 冯雪. 血清CEA、CA125、CA153联合检测在乳腺癌诊断中的应用价值研究. 中国医药科学, 2013, 3(8):121-122.
27.	吕海军. 血清中CA153、CA125和CEA联合检测对乳腺癌的诊疗价值探讨. 中国实用医药, 2011, 6(33):109-110.
28.	孙丽琴. 肿瘤标记物联合检测乳腺癌的优越性. 航空航天医学杂志, 2013, 24(12):1502-1503.
29.	Whiting PF, Weswood ME, Rutjes AWS, 等. QUADAS评价:一种用于诊断性研究的质量评价工具(修订版). 中国循证医学杂志, 2007, 7(7):531-536.
30.	张天嵩, 钟文昭. Meta-Disc软件在诊断试验Meta分析中的应用. 循证医学, 2008, 8(2):97-108.
31.	陈智周, 范振符, 杨剑. 肿瘤标志物CA153的免疫放射分析及其临床应用. 中华肿瘤杂志, 1998, 20(2):125.
32.	Harris L, Fritsche H, Mennel R, et al. American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. J Clin Oncol, 2007, 25(33):5287-5312.
33.	Dupont WD, Parl FF, Hartmann WH, et al. Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer, 1993, 71(04):1258-1265.
34.	Bast RC Jr, Klug TL, St John E, et al. A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer. N Engl J Med, 1983, 309(15):883-887.
35.	陈光意, 苏金明, 吕晓娴. CEA、CAl53及CAl25对乳腺癌的诊断. 中国误诊学杂志, 2005, 5(5):871-872.
36.	陈建伟, 宋建国. CAl53、CEA及CAl25联合检测对乳腺癌诊断的意义. 上海医学检验杂志, 2000, 15(4):256.
37.	Walter SD. Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. J Stat Med, 2002, 21(12):1237-1256.

1. Jemal A, Siegel R, Xu JC, et al. Cancer statistics. CA, 2010, 60(5):277-300.
2. Anderson BO, Shyyan R, Eniu A, et al. Breast cancer in limited-resource countries:an overview of the Breast Health Global Initiative 2005 guidelines. Breast J, 2006, 12(Suppl 1):3-15.
3. 贺延莉, 靳二虎. 乳腺癌的影像学诊断进展. 国际医学放射学杂志, 2008, 31(4):235-239.
4. 张嘉庆, 王殊, 乔新民. 乳腺癌的现状和远景. 中华外科杂志, 2002, 40 (3):161-163.
5. Park BW, Oh JW, Kim JH, et al. Preoperative CA153 and CEA serum levels as predictor for breast cancer outcomes. Ann Oncol, 2008, 19(4):675-681.
6. Geng B, Liang MM, Ye XB, et al. Association of CA 15-3 and CEA with clinicopathological parameters in patients with metastatic breast cancer. Mol Clin Oncol, 2015, 3(1):232-236.
7. Gao J, Zhang Q, Xu J, et al. Clinical significance of serum miR-21 in breast cancer compared with CA153 and CEA. Chin J Cancer Res, 2013, 25(6):743-748.
8. 易琳, 刘兴明, 林丁, 等. 血清CAl53、CAl25、CEA联合检测在乳腺癌诊断中的价值. 重庆医科大学学报, 2012, 37(9):802-805.
9. 张木坤, 刘露, 黄仁青, 等. 血清CAl53、CAl25和CEA联合检测在乳腺癌临床诊疗中的应用. 国际医药卫生导报, 2012,18(9):1321-1323.
10. 王景萍, 洪锡田, 盛家和. 联合检测血清糖类抗原153、糖类抗原125、癌胚抗原在乳腺癌中的诊断价值探讨. 河南医学研究, 2007, 16(3):243-245.
11. 陈军. CAl53、CAl25、CEA联合检测在乳腺癌的临床应用. 临床和实验医学杂志, 2007, 6(10):94-95.
12. 张敏, 景永. 三种肿瘤标志物联合检测在乳腺癌诊断中的临床价值. 中国现代药物应用, 2010, 4(14):48-49.
13. 韩媛媛, 李新杰, 王萍, 等. 3项肿瘤标志物检测对乳腺癌的诊断价值. 检验医学与临床, 2012, 9(22):2859-2860.
14. 陈艺文. CAl53、CAl25及CEA联合检测对乳腺癌诊断的意义. 农垦医学, 2012, 34(5):401-403.
15. 田雪玲, 秦林其, 王艳敏. 血清CA125, CA153, CEA联合检测在乳腺癌诊断的意义. 中国实用医药, 2012, (6):87-88.
16. 陈秋芸. CA125、CA153、CEA联合检测在乳腺癌诊断中的临床意义. 中国医药指南, 2011, 9(27):70-71.
17. 邱厚匡, 张智, 张珍, 等. 多种肿瘤标志物联合检测对乳腺癌诊断的临床意义. 临床医学工程, 2011, 18(6):860-861.
18. 钱海英. 肿瘤标志物CAl53、CAl25、CEA联合检测在乳腺癌中的临床应用. 医学检验与临床, 2008, 19(2):32-33.
19. 左新华, 周斌. CAl53、CAl25、CEA联合检测在乳腺癌诊断中的应用价值. 中国医药科学, 2011, 1(10):135-136.
20. 范柳笛. CA153、CEA、CA125 联合检测对乳腺癌诊断的意义研究. 临床医学, 2013, 26(16):102-103.
21. 练治平. CA153、CEA及CA125联合检测对乳腺癌诊断的意义. 国际医药卫生导报, 2012, 18(18):2753-2755.
22. 陈光意, 苏金明, 吕晓娴. CEA、CA153及CA125对乳腺癌的诊断. 中国误诊学杂志, 2005, 5(5):871-872.
23. 叶蓓, 柳光宇, 陆劲松, 等. 常用的乳腺癌血清肿瘤标志物在早期诊断中的应用价值不高. 中国癌症杂志, 2009, 19(10):807-808.
24. 陈士华. 联合检测CA153、CA125、CEA对乳腺癌的临床价值探讨. 检验医学, 2013, 28(3):235-237.
25. 吴爱祝, 蔡俊宏, 梁茱, 等. 血清CEA、CA125、CA153联合检测在乳腺癌诊断中的应用. 山东医药, 2011, 51(30):94-95.
26. 吕蕾, 冯雪. 血清CEA、CA125、CA153联合检测在乳腺癌诊断中的应用价值研究. 中国医药科学, 2013, 3(8):121-122.
27. 吕海军. 血清中CA153、CA125和CEA联合检测对乳腺癌的诊疗价值探讨. 中国实用医药, 2011, 6(33):109-110.
28. 孙丽琴. 肿瘤标记物联合检测乳腺癌的优越性. 航空航天医学杂志, 2013, 24(12):1502-1503.
29. Whiting PF, Weswood ME, Rutjes AWS, 等. QUADAS评价:一种用于诊断性研究的质量评价工具(修订版). 中国循证医学杂志, 2007, 7(7):531-536.
30. 张天嵩, 钟文昭. Meta-Disc软件在诊断试验Meta分析中的应用. 循证医学, 2008, 8(2):97-108.
31. 陈智周, 范振符, 杨剑. 肿瘤标志物CA153的免疫放射分析及其临床应用. 中华肿瘤杂志, 1998, 20(2):125.
32. Harris L, Fritsche H, Mennel R, et al. American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. J Clin Oncol, 2007, 25(33):5287-5312.
33. Dupont WD, Parl FF, Hartmann WH, et al. Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer, 1993, 71(04):1258-1265.
34. Bast RC Jr, Klug TL, St John E, et al. A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer. N Engl J Med, 1983, 309(15):883-887.
35. 陈光意, 苏金明, 吕晓娴. CEA、CAl53及CAl25对乳腺癌的诊断. 中国误诊学杂志, 2005, 5(5):871-872.
36. 陈建伟, 宋建国. CAl53、CEA及CAl25联合检测对乳腺癌诊断的意义. 上海医学检验杂志, 2000, 15(4):256.
37. Walter SD. Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. J Stat Med, 2002, 21(12):1237-1256.

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Diagnostic Value of the Combined Test of Serum CA153, CA125 and CEA in Detection of Breast Cancer: A Meta-analysis

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