血清CA15-3和CEA对转移性乳腺癌化疗疗效的预测作用

Role of CA15-3 and CEA in predicting response during chemotherapy in metastatic breast cancer

目的分析转移性乳腺癌患者在接受化疗时及化疗后随访期间血清CA15-3和CEA的变化情况,探讨二者对化疗疗效的预测作用。方法治疗期间每2个周期以及随访期间每3月检测血清CA15-3和CEA,并通过影像学检查判断化疗疗效,分析血清标志物变化与化疗疗效的关系。结果疗效部分缓解(PR)的患者CA15-3及CEA在化疗期间明显降低(P<0.05);疾病稳定(SD)<1年组CA15-3和CEA出现明显升高,而SD≥1年组CA15-3在治疗第4周期时出现降低(P<0.05)。疾病进展(PD)患者血清CA15-3及CEA在治疗期间出现明显升高(P<0.05)。再次PD组患者CA15-3在进展前3月与进展时均有明显升高(P<0.05);CEA则在进展时出现有意义的升高。分析CA15-3升高组、CEA升高组、CA15-3及CEA同时升高组无进展生存情况,发现CA15-3和CEA同时升高组无进展生存率最低,肿瘤复发进展最快。结论CA15-3与CEA明显升高多可提示转移性乳腺癌化疗期间或随访期间的疾病进展,若出现明显降低则可能预示化疗疗效较好,二者同时检测,其结果较单一标志物准确度高。

Objective To analyze the variation of CA15-3 and CEA during chemotherapy and follow-up in metastatic breast cancer,and to explore their predicting role to chemotherapy response.Methods CA15-3 and CEA were detected every two cycles during treatment,every 3 months during follow-up to judge the chemotherapy response through imageology examination.The relationship between the variation of CA15-3 and CEA and the chemotherapy response was analyzed.Results In patients with partial response（PR）,CA15-3 and CEA decreased during the treatment（P〈0.05）.In patients with stable disease（SD）〈1 year,CA15-3 and CEA showed significant increase（P〈0.05）.However,the CA15-3 levels in the patients with SD≥1 year decreased significantly after 4 cycles（P〈0.05）.In disease progression（PD） group significant increase of CA15-3 and CEA could be noted.In the patients with secondary PD,CA15-3 showed an obvious increase 3 months before progression and at the point of progression（P〈0.05）.CEA increased significantly at progression.Conclusions The obvious increase of CA15-3 and CEA can predict disease progression during chemotherapy or follow-up in the metastatic breast cancer patients.And the conspicuous decrease of CA15-3 and CEA usually shows a good result of treatment.It is more accurate to use both of CA15-3 and CEA than one.