VEGF、CA15-3、CA125和CEA在乳腺癌预后判断中的表达及意义

Clinical Significance of Determination of Expressions of VEGF,CA15-3,CA125 and CEA for Outcome Prediction in Patients with Breast Cancer

目的:探讨血清血管内皮生长因子(VEGF)、CA15-3、CA125和CEA水平在乳腺癌预后判断中的临床意义。方法:免疫组化(S-P)法动态监测93例乳腺癌患者的VEGF水平,化学发光免疫分析检测CA15-3、CA125和CEA的水平,并与40例正常对照组的各项指标进行比较,分析其与临床分期、治疗效果和复发转移的关系。结果:乳腺癌组的VEGF随乳腺癌(Ⅰ～Ⅳ)期依次升高,有淋巴结转移者较无转移患者高,差异有统计学意义(P<0.01);乳腺癌患者中(Ⅲ、Ⅳ)期的CA15-3、CA125和CEA水平也明显高于正常对照组和(Ⅰ、Ⅱ)期患者组,有淋巴结转移患者显著高于无淋巴结转移患者,差异均有统计学意义(P<0.05);随访中发现复发者各项指标均比无复发者高;VEGF、CA15-3、CA125和CEA的表达与临床分期、腋窝淋巴结状况有关(P<0.01),但与患者年龄、肿瘤大小和肿瘤病理学类型无关(P>0.05)。结论:VEGF、CA15-3、CA125和CEA的联检对于判断乳腺癌的分期、转移情况及治疗效果有一定意义,可以指导临床对乳腺癌的诊疗工作。

Objective To study the clinical significance of determination of VEGF, CA15 -3, CA125 and CEA expressions for outcome prediction in patients with breast cancer. Methods Tumor tissue VEGF expression （with immunohistocbemistry） and serum CA15 -3, CA125, CEA （with CLIA） levels were determined in 93 patients with breast cancer. These parameters were re -examined in these patients （3 months to 2years later） and the results in 71 patients without recurrence and 22 patients with recurrence were compared. Results The VEGF expressions in patients with breast cancer increased gradually along with the advancing from stage I to stag IV. VEGF expressions in patients with regional lymph node metastasis were significantly higher than those in patients without lymph node metastasis （P 〈 0.01 ）. The serum levels of CA15 -3, CA125 and CEA in patients of stage Ⅲ and Ⅳ were significantly higher than those in patients of stage Ⅰ and Ⅱ and controls （P〈0.05）. Serum markers levels in patients with lymph node metastasis were significantly higher than those in patients without metastasis （P 〈 0.05 ）. The serum markers levels in patients with recurrence were significantly higher than those in patients without recurrence （ P 〈 0.05, P 〈 0.01 ）. Expressions of VEGF, CA15 - 3, CA125 and CEA were positively correlated with the clinical stage and presence of lymph node metastasis. Conclusion Combined detection of VEGF, CA15 -3, CA125 and CEA expressions would be helpful for assessment of the disease process and outcome prediction in patients with breast cancer.