摘要
目的探讨血清卵泡刺激素(FSH)和黄体生成素(LH)水平在克氏综合征患者乳腺肿块良恶性临床鉴别中的应用及其价值。方法在潜江地区已确诊克氏综合征患者普查的基础上,2015年1月至2017年12月对68例克氏综合征患者的临床资料进行回顾性分析,以行乳腺手术治疗的23例克氏综合征乳腺癌患者作为乳腺癌组,以45例排除乳腺癌的克氏综合征患者作为对照组。比较两组患者FSH、LH、睾酮(T)和泌乳素(PRL)水平,应用ROC曲线分析其取不同截断值的诊断效能。结果乳腺癌组FSH、LH和T水平显著高于对照组(P=0.000,0.000,0.008),两组PRL水平无统计学差异(P=0.757);ROC曲线显示,FSH、LH和T的AUC分别为0.944、0.746和0.738,其中FSH对乳腺癌的诊断效能均高于LH和T(P=0.002,0.002);约登指数提示FSH、LH和T水平诊断乳腺癌的最佳截断值分别为47.722 mIU/ml、22.731 mIU/ml和1.632 ng/ml;FSH、LH和T位于最佳截断值时,FSH诊断克氏综合征乳腺癌的准确率、灵敏度、阳性预测值和阴性预测值均显著高于LH和T(P<0.05)。结论在克氏综合征患者乳腺肿块良恶性的鉴别诊断中,FSH的准确率和灵敏度高,具有重要的临床意义。
Objective To investigate the clinical value of serum follicle stimulating hormone(FSH) and luteinizing hormone(LH) levels in differentiating benign masses from malignant breast masses in patients with Klinefelter syndrome(KS).Methods Based on the general survey of KS in Qianjiang area,68 patients confirmed with KS treated from January 2015 to December 2017 were retrospectively studied,in whom the patients with breast cancer underwent breast surgery were designed as breast cancer group(n=23),and the patients( excluding breast cancer) were designed as control group(n=45).The levels of FSH,LH,testosterone(T) and prolactin(PRL) were compared between two groups,and their diagnostic efficacy at different truncation values were analyzed by receiver operating characteristic(ROC) curve.Results The levels of FSH,LH and T in breast cancer group were significantly higher than those in control group(P=0.000,0.000,0.008),but there was no significant difference in PRL level between two groups(P=0.757).ROC curve showed that the area under curve(AUC) of FSH,LH and T were 0.944,0.746 and 0.738,respectively.The diagnostic efficiency of FSH for breast cancer was significantly higher than those of LH(P=0.002) and T(P=0.002).Youden′s index indicated that the best cut-off points of FSH,LH and T were 47.722 mIU/ml,22.731 mIU/ml and 1.632 ng/ml,respectively for diagnosing breast cancer,and the accuracy,sensitivity,positive predictive value and negative predictive value of FSH diagnosing breast cancer with KS were significantly higher than those of LH(all P<0.05) at these best cut-off points.Conclusion FSH has high accuracy and sensitivity in differential diagnosis of benign and malignant breast masses in patients with KS and has important clinical significance.
作者
徐莉芳
童芳芳
谭代林
XU Li-fang;TONG Fang-fang;TAN Dai-lin(Department of Blood Transfusion,Qianjiang Central Hospital Affiliated to Wuhan University, Qianjiang,Hubei 433100,China)
出处
《中国临床研究》
CAS
2019年第9期1197-1200,共4页
Chinese Journal of Clinical Research
基金
湖北省卫生计生委基金(WJ2016-YZ-16)~~
关键词
卵泡刺激素
黄体生成素
克氏综合征
乳腺肿块
乳腺癌
鉴别
Follicle stimulating hormone
Luteinizing hormone
Klinefelter syndrome
Breast mass
Breast cancer
Differentiate
