ObjectiveTo explore the classification of ultrasound breast imaging reporting and data system (BI-RADS) classification combined with serum trefoil factor 1 (TFF1) and human growth differentiation factor 3 (GDF3) in the differential diagnosis of benign and malignant breast masses. MethodsThe prospective study collected 113 female patients with breast masses who got treatment in Tangshan People’s Hospital from September 2020 to September 2023. Ultrasound diagnostic equipment was applied for ultrasound BI-RADS classification, ELISA method was applied to detect serum TFF1 and GDF3 levels, Consistency Kappa test was used to compare the consistency of ultrasound BI-RADS classification, serum TFF1 and GDF3 alone and combined in the diagnosis of benign and malignant breast masses and pathological results, In addition, receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the above indicators in the diagnosis of benign and malignant breast masses. ResultsAmong the 113 patients with breast mass, the pathological diagnosis showed benign mass in 48 cases and malignant mass in 65 cases. The serum levels of TFF1 [(1.62±0.25) μg/L vs (1.24±0.27) μg/L] and GDF3 [(118.62±21.73) ng/L vs (96.47±16.05) ng/L] in malignant patients were obviously higher than those in benign patients (P<0.001). There were 70 cases of malignant breast masses and 43 cases of benign breast masses according ultrasound BI-RADS classification combined with serum TFF1 and serum GDF3. The diagnosis consistency with pathological results was very high and Kappa value was 0.835 (P<0.001). The sensitivity and specificity of ultrasound BI-RADS classification combined with serum TFF1 and serum GDF3 in differential diagnosis of benign and malignant breast masses were 96.92% (63/65), 85.42% (41/48), respectively, the negative predictive value was 95.35% (41/43), and positive predictive value was 90.00% (63/70). The sensitivity, negative predictive value and accuracy were higher than those of ultrasonic BI-RADS classification and serum GDF3 alone (P<0.05), and the missed diagnosis rate was lower than that of ultrasonic BI-RADS classification and serum GDF3 alone (P<0.05). ConclusionsThe serum levels of TFF1 and GDF3 increase in patients with malignant breast masses. The combination of ultrasound BI-RADS classification and serum TFF1 and GDF3 can improve the sensitivity and accuracy of the diagnosis of benign and malignant breast masses, and reduce the missed diagnosis rate.
目的 探討酶聯免疫吸附試驗(ELISA)檢測血清甲胎蛋白異質體(AFP-L3)含量對原發性肝癌（PLC）的診斷價值。 方法 選擇2011年3月－11月門診或住院的137例患者臨床檢測甲胎蛋白(AFP)為陽性的肝病患者血清，應用上海逸峰生物科技有限公司提供的ELISA法AFP-L3檢測試劑盒檢測AFP-L3濃度，137例中男98例，女39例，年齡28～77歲。其中PLC 92例，良性肝病45例，后者包括肝硬化37例、慢性肝炎8例。分析PLC組與良性肝病組AFP-L3濃度差異，運用受試者工作特征曲線(ROC)分析AFP-L3含量在PLC鑒別診斷中的價值。 結果 PLC組AFP-L3濃度[（109.04 ± 62.51）ng/mL]明顯高于良性肝病組[（25.96 ± 49.43）ng/mL，兩組差異有統計學意義（t=8.28 ，P＜0.001）。ROC分析結果顯示，曲線下面積為0.819，以AFP-L3濃度37.89 ng/mL為臨界值，分析92例PLC患者與45例良性肝病患者AFP-L3濃度異常的靈敏度為83.69%，特異度為88.88%，陽性預測值為93.90%（77/82），陰性預測值為72.72%（40/55），診斷準確度為85.40%。 結論 應用簡便快速的ELISA法檢測AFP-L3濃度在PLC與良性肝病鑒別診斷中具有較高的臨床價值，便于臨床推廣。