乳腺癌新辅助化疗前后血清CA15-3水平变化及其与疗效的关系

Relationship between the variation of serum CA15-3 level and curative efficacy of neoadjuvant chemotherapy in local advanced breast cancer

目的:探讨局部进展期乳腺癌新辅助化疗前后血清CA15-3水平变化及其与疗效的关系。方法:2002年-2006年应用CEF(环磷酰胺+表阿霉素+氟尿嘧啶)方案对96例IIb-III期乳腺癌患者进行新辅助化疗。28天为1个周期,新辅助化疗2个周期后评价疗效。于治疗前1天及治疗2周期后采外周静脉血5ml,用电化学发光免疫法检测血清CA15-3水平。结果:新辅助化疗总有效率为47.9%(46/96),其中38例(39.6%)降低了临床分期,完全缓解7例,部分缓解39例,无疾病进展者。96例乳腺癌患者化疗前CA15-3阳性率为64.6%(62/96)。CA15-3阳性组和阴性组总有效率分别为45.2%(28/62)、52.9%(18/34),无显著性差异(P>0.05)。化疗前血清CA15-3水平为45.8±6.3;化疗后为32.5±6.8,较化疗前显著下降(P<0.05)。其中临床完全缓解和部分缓解患者血清CA15-3水平化疗后较化疗前均有一定程度下降(P<0.05);而病情稳定患者血清CA15-3水平较化疗前无显著下降(P>0.05)。结论:新辅助化疗前后血清CA15-3水平变化与临床疗效有一定的相关性,动态监测血清CA15-3可预测疗效。

Objective：To investigate the relationship between the variation of serum CA15 -3 level and curative efficacy of neoadjuvant chemotherapy in local advanced breast cancer（LABC）. Methods： During the period 2002 - 2006, 96 patients with stage Ⅱb - Ⅲ breast cancer were treated with CEF regimen for 2 cycles every 28 days. Accroding to the effect standard suggested by WHO efficacy was evaluated after two cycles of neoadjuvant chemotherapy. Patients received cyclophosphamide （CTX） 500 mg/m^2 on day1,8; epimbincin （EPI） 50 mg/m^2 on day1,8; 5 - fluorouracil （5 -Fu） 500 mg/m^2 on day1,8. The serum CA15 -3 level was measured by electrochemil immunoassay （ECLI） before chemotherapy and after 2 cycles of chemotherapy. Results： The overall response rate （RR） of the primary tumor was 47.9% （46/96）. There was no disease progressive （ PD）, complete response （CR） in 7 cases, partial response （PR） in 39 cases. The positive rate of CA15 - 3 before chemotherapy was 64.6% （62/ 96）. The overall response rate in CA15 -3 positive and CA15 -3 negative breast cancer were 45.2% （28/62） and 52.9% （18/34） respectively, which was no significant difference. CA15 -3 level before chemotherapy and after chemotherapy were 45.8 ± 6.3 and 32.5 ± 6.8 in 96 local advanced breast cancer patients. CA15 - 3 level after chemotherapy was significantly lower than before chemotherapy in both complete response and partial response patients, while it was no significant change in stable disease cases. Conclusion： There is a significant correlation between the variation of serum CA15 -3 level and curative efficacy of neoadjuvant chemotherapy in LABC patients. Sequential monitoring of serum CA15 -3 level is valuble for predicting curative effect.