检测乳腺癌患者术后血清肿瘤指标的临床价值

Clinical value of detecting serum tumor markers in postoperative breast cancer patients

目的研究乳腺癌患者术后血清CA15-3、CEA和CA-125水平与乳腺癌各种临床资料以及病情转归的关系。方法收集我院收治的临床信息完整的219例乳腺癌术后病例。应用化学发光免疫法检测血清CA15—3、CEA和CA-125浓度，统计分析其与各临床参数以及病情转归的关系。结果乳腺癌转移时，血清CA15—3、CEA和CA-125水平均明显高于未转移组（P=0．000），且三项指标联合检测敏感性达64．1％。转移时血清CA-125和CA15—3水平与ER呈正相关（PCA-125=0．049，PCA15-3=0．039）。多脏器转移者血清CA15-3、CEA和CA-125浓度明显高于单脏器转移者（P=0．000）。远处转移病例CA15-3和CEA水平与局部复发病例存在统计学差异（PCA15-3=0．001，PCEA=0．022）。结论血清CA15—3、CEA和CA-125浓度升高与否是监测乳腺癌转移的有效指标。乳腺癌转移时血清CA15—3和（或）CA-125浓度升高可提示患者对内分泌治疗更敏感。

Objective To investigate the relationship between serum levels of CA15-3, CA-125 and CEA in postoperative breast cancer patients and clinicopathological parameters and pathogenetic condition turn- over. Methods From January 2004 to December 2007, 219 breast disease eases with integrity clinical information, admitted to general surgery and oneology department of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, were collected. The serum concentrations of CA15-3, CA-125 and CEA were determined by chemiluminescent immunoassay （CLIA）. Wileoxon Kruskal Wallis analysis, erosstable analysis and spearman correlation analysis were used to investigate the association between the serum concentration and clinical parameters and pathogenetic condition tuinover. Results The serum concentrations of CA15-3,CA-125 and CEA in metastatic breast cancer group were significantly higher than those in nonmetastatic group （ P = 0. 000 ）. The sensitivity of the 3 tumor markers in combination was 64.1% in metastatic breast cancer diagnosis. CA15-3 and CA-125 at the time of initial metastasis were correlated with estrogen receptor state（ PCA15-3 = 0. 039, PCA-125 = 0. 049）. The level of 3 tumor markers in multiorgan metastatic group were significantly higher than those in single organ metastastic patients（ P = 0.000）. There were significant differences between the levels of CA15-3 and CEA in distant metastatic group and those in local metastatic group （PCA15-3 = 0. 001, PCEA = 0. 022）. Conclusion The high serum concentrations of CA15-3, CEA and CA-125 were useful in monitoring the metastasis. The high serum levels of CA15-3 and/or CA-125 may indicate that the patients will be more sensitive to endocrine therapy.