乳腺癌患者血清Her2-ECD、CA15-3、TPS检测的临床意义

The Value of Detection of Serum Her2-ECD,CA15-3 and TPS in Patients Suffered Breast Cancer

为了评价血清Her2-ECD、CA15-3、TPS检测在各期乳腺癌中的应用价值,通过测定45例乳腺癌患者、30例乳腺良性病变患者和30名正常人血清Her2-ECD、CA15-3、TPS水平,分析其在辅助诊断、疗效观察和预后判断中的价值。结果表明,早期乳腺癌患者血清CA15-3、Her2-ECD与良性乳腺疾病患者及正常对照组之间无显著性差异,TPS在早期乳腺癌患者中虽有升高,但诊断灵敏度和特异性过低(44.00%,33.33%);晚期、复发转移乳腺癌病人三项指标均明显高于其他各组,但相互间无明显相关性。Wilcoxon检验结果表明,三项指标术后均明显低于术前(P<0.05),个别术后指标升高者预后不佳。绝经与否、肿瘤直径、淋巴结转移、ER、PR等5项因素对三项肿瘤标志物的血清水平没有影响,晚期乳腺癌患者CA15-3和Her2-ECD阳性率明显高于早期患者,而TPS水平与肿瘤分期无关。血清Her2-ECD水平与组织Her2 IHC结果较为一致。结论:CA15-3、TPS和Her2-ECD三项血清学指标都不具备乳腺癌早期诊断的价值,但是三项指标从肿瘤生物活性的不同侧面提供了有价值的信息,对于上述指标升高的早期乳腺癌患者,连续动态监测将有助于判断疗效、疾病进展和预后。血清Her2-ECD作为Her2 IHC和FISH检测的有效补充和延续手段,可对各期乳腺癌的治疗、疗效观察和判断预后提供其独立而客观的参考信息。

To explore the value of tumor maker human serum HER2 extracellular domain（Her2-ECD） combined with CA15-3 and tissue polypeptide specific antigen（TPS） in patients suffered breast cancer,the serum levels of Her2-ECD,TPS and CA15-3 in 45patients with breast cancer,30 women with benign mass and 30 control cases were measured by ELISA.The value of aided diagnosis,curative effect observation and evaluating prognosis were analyzed.The results showed that the serum levels of the three biomarkers in early-stage breast cancer were not significantly different compared with benign and control cases.The TPS were demonstrated significantly higher serum levels in early-stage breast cancer,but the diagnostic sensitivity and specificity（44.00%,33.33%）were too low to meet the demand of early diagnosis.For the advanced and metastasized malignancy,the three serum biomarker levels were significantly higher than that of benign and control cases,and the post-operation levels were lower compared with pre-operation according to the Wilcoxon test results（P0.05.The menopause,tumor size,lymph node metastasis,ER and PR had no effect on the serum levels of the biomarkers.The positive ratios of CA15-3 and Her2-ECD in advanced malignancy were significantly higher than early-stage patients.The serum levels of Her2-ECD were analogous to Her2（IHC） in tissues.Although there were no values for early diagnostic in breast cancer,the serum levels of CA15-3,TPS and Her2-ECD provided worthy information respectively in different aspects.Continuous monitoring conduced to observe the curative effect,disease progression and to evaluate prognosis.As a supplement and extending of Her2 analysis with IHC and FISH,serum Her2-ECD levels could provide independent and impersonal information in the diagnosis and therapy of breast cancer.