The clinical study of combined detection of serum prostate specific antigen and cytokeratin 19 fragment antigen 21-1 in pathological stages of breast cancer

Objective To observe the clinical efficacy of combined detection of serum prostate specific antigen (PSA) and CYFRA21-1 in breast cancer patients with pathological staging. Methods 200 cases of breast cancer patients were randomly selected from January 2015 to January 2016 in our hospital as the observation group; at the same time 200 cases of benign breast disease patients were selected as the control group. The serum levels of PSA and CYFRA21-1 were detected, and the clinical value of monitoring the disease during the early diagnosis and treatment of breast cancer was analyzed according to the test results. Results By comparison, the observation group free PSA (fPSA) in serum (0.19±0.04) ng/ml, total PSA (tPSA) (22.45±3.16) pg/ml was significantly lower than the control group fPSA (0.35±0.08) ng/ml, tPSA (31.48±4.31) pg/ml; CYFRA21-1 (5.34±1.13) ng/ml was significantly higher than the control group (3.67±1.07) ng/ml (t=1.267, P=0.031; t=4.891, P=0.028; t=2.534, P=0.026). The positive rate of serum fPSA, tPSA, CYFRA21-1 and 3 joint tests in observation group was higher than that in control group (χ2=3.287, P=0.012; χ2=2.936, P=0.028; χ2=13.587, P=0.000; χ2=11.279, P=0.000). There were 200 cases of breast cancer in the observation group confirmed by pathology, of which stage Ⅰ-Ⅱ 73 cases, stage Ⅲ 76 cases, and stage Ⅳ 51 cases. The serum levels of fPSA and tPSA in patients with stage Ⅳ breast cancer were significantly lower than those of Ⅰ-Ⅱ and Ⅲ breast cancer patients, and the content of CYFRA21-1 was significantly higher than that in patients with stage Ⅰ-Ⅱ and Ⅲ. The serum levels of tPSA and fPSA in patients with stage Ⅲ breast cancer were significantly lower than those in stage Ⅰ-Ⅱ, and the serum CYFRA21-1 content was significantly higher than that in stage Ⅰ-Ⅱ breast cancer patients (stage Ⅳ compared with stage Ⅲ, t=0.783, P=0.019; t=1.524, P=0.021; t=2.875, P=0.014). The combined detection of tPSA+ fPSA+ CYFRA21-1 could increase the sensitivity of patients to 91.70%, improved the specificity to 92.8%, and improved the accuracy of diagnosis to 94.8%, which was higher than the single test (cooperative detection compared with single CYFRA21-1, χ2=2.357, P=0.019; χ2=4.398, P=0.038; χ2=3.176, P=0.029). Conclusion PSA combined with CYFRA21-1 detection could effectively improve the early diagnosis rate of breast cancer, and provided an important auxiliary diagnostic basis for clinical staging, efficacy evaluation and prognosis diagnosis of breast cancer patients. Key words: Combined detection; Breast cancer; Case staging; Prostate specific antigen; Cytokeratin 19 fragment antigen 21-1