乳腺癌肿瘤标志物阳性率的相关因素分析

An Analysis of Correlation Factors of the Positive Rate of Breast Cancer Serum Tumor Markers

目的:研究肿瘤标志物CEA、CA125、CA15-3在乳腺癌中的诊断价值,对影响肿瘤标志物阳性率的相关因素进行分析。方法:收集111例手术病理确诊为乳腺癌患者,研究各个肿瘤标志物的阳性率,并就患者的发病年龄、月经状态、病变部位、皮肤桔皮样改变、肿块大小、淋巴结转移情况、远处转移、分期、病理类型、ER、PR、c-erbB-2、P53和BCL-2等共14项因素与肿瘤标志物阳性率的相关情况进行单因素方差分析和lo-gistic回归模型。结果:CEA、CA125、CA15-3和联检的阳性率分别为10.1%、10.8%、9.1%和13.8%。单因素分析和多因素分析均显示与乳腺癌肿瘤标志物阳性率显著相关的因素有:肿瘤分期(χ2=17.258,P=0.001)、皮肤改变(χ2=9.923,P=0.002)、远处转移(χ2=7.28,P=0.007)。单因素分析显示P53显著相关(χ2=10.45,P=0.005),但多因素分析显示无统计学意义(waldχ2=1.334,P=0.248)。其余因素两个分析的结果均显示无统计学意义。结论:联检可以提高乳腺癌肿瘤标志物阳性率。肿瘤分期、皮肤改变和远处转移与肿瘤标志物阳性率显著相关,P53的相关性有待进一步研究。

Objective To study the diagnosis value of serum tumor markers CEA, CA125, CA15 - 3 in breast cancer, and the correlation factors of positive rate of these serum tumor markers. Methods Positive rates of the tumor markers CEA, CA125, CA15 - 3 were determined and both single factor （x^2 test） and multifactor analysis （ logistic regression） of the correlations with 14 variables were studied. The parameter involved were ： age of disease, menstrual status, tumor location, change of skin, tumor size, lymph node metastasis, distant metastasis , clinical stage, pathological stage, expression of estrogen receptor（ ER）, progesterone receptor（PR） , c -erbB- 2, P53 and BCL- 2 in tumor tissue,Results the, Results The positive rate of CEA, CA125, CA15 -3 and combination test was 10. 1%, 10.8%, 9.1% and 13.8% respectively. Both single factor and multifactor analysis showed tumor stage （x^2 = 17. 258, P = 0. 001 ）, change of skin （x^2 = 9.923, P = 0. 002）, distant metastasis （x^2= 7.28, P = 0.007 ） were significantly correlated with the positive rate of tumor markers. Single factor analysis demonstrated significant correlation with P53 （x^2 = 10.45, P = 0. 005 ）, but not so for multifactor analysis （ Waldx^2 = 1. 334 ,P = 0.248 ）. Conclusion Three parameters, namely tumor stage, change of skin, distant metastasis were significantly correlated with the positive rate of tumor markers. The correlation of P53 was inconclusive.