CA15-3和CEA检测在乳腺癌诊疗中的临床意义

The Clinical Significance of CA15-3 and CEA Detection in Breast Cancer Diagnoses and Treatment

目的探讨糖蛋白抗原(CA15-3)和癌胚抗原(CEA)检测在乳腺癌诊疗中的临床意义。方法测定362例乳腺癌患者手术或化疗前后血清CA15-3和CEA,并与121例乳腺良性肿瘤患者比较。结果I期乳腺癌与良性肿瘤组比较CA15-3、CEA差异无显著性(P>0.05),II期、III期乳腺癌患者的CA15-3、CEA平均水平高于良性肿瘤组(P<0.01),阳性率分别为8.6%、17.4%和7.8%、13.0%。IV期乳腺癌患者的CA15-3、CEA平均水平高于上述四组(P<0.01),阳性率达到90.4%和82.9%。手术后无复发转移的患者CA15-3、CEA平均水平和阳性率与手术前比较差异无显著性(P>0.05)。而术后复发转移的患者CA15-3、CEA的平均水平和阳性率明显高于术前(P<0.01)。化疗后病情缓解的患者CA15-3、CEA平均水平和阳性率低于化疗前(P<0.01),化疗后未缓解或病情发展的患者CA15-3、CEA平均水平和阳性率高于化疗前(P<0.05)。结论CA15-3和CEA的检测可作为乳腺癌术后随访、判断乳腺癌是否转移以及化疗效果评价的重要指标。

Objective To discuss the clinical significance of CA15-3 and CEA detection in Breast Cancer Diagnoses and Treatment. Method Examine the CA15-3 and CEA of 362 patients before and after the operation or chemotherapy, and compare it with 121 benign tumor patients. Result Compared phase Ⅰof the breast cancer and benign tumor, the level of CA15-3 and CEA do not differ much （P 〉 0.05 ）, but wich in phase Ⅱand phase Ⅲ of the breast cancer exceed the benign tumor （ P 〈 0. 01 ）, the positive rate is 8.6%, 17.4% and 7. 8% ,13.0% respectively. The level of CA15-3 and CEA In phase Ⅳ exceed the above four groups （P 〈 0. 01 ）, and the positive rate is 90. 4% and 82. 9% respectively. In the case of patients without recrudescence and metastasis after operations, the level of CA15-3 and CEA and the positive rate are not significantly different compared with the situation in the pre-operation （P 〉 0.05 ）. But wich of the patients with recrudescence and metastasis after the operation are higher than the situation in the pre-operation （P 〈 0. 01 ）. The level of CA15-3 and CEA and the positive rate of patients in remission from the illness after the chemotherapy are lower than the situation before the chemotherapy （ P 〈 0. 01 ）, and wich of patients in not remission from the illness after the chemotherapy are higher than the situation before the ehemotherapythe （ P 〈 0. 05 ）. Conclusion CA15-3 and CEA detection can be adopted as an approach of follow-up after breast cancer operation, to determine cancer metastasis and estimate the effectiveness of the chemotherapy.