血清CA15-3水平与转移性乳腺癌不同分子亚型的相关性分析

Correlation between serum CA15-3 level and the molecular subtypes of metastatic breast cancer

目的:回顾性分析血清CA15-3水平与转移性乳腺癌不同分子亚型的相关性。方法:收集268例转移性乳腺癌患者,采用免疫放射分析法(immunoradiometric assay,IRMA)检测其静脉血CA15-3值,免疫组织化学和荧光原位杂交(fluorescence in situ hybridization,FISH)法分析其雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)表达水平。患者按受体状态分为3组:(1)腔上皮型,即ER+,不论PR和HER-2状态;(2)HER-2过表达型,即ER-PR-HER-2+;(3)基底细胞样型,ER-PR-HER-2-。比较各组间血清CA15-3值及其增高的差异。结果:3组间CA15-3检测均值有显著差异(腔上皮型组96U/mL,HER-2过表达型组52U/mL,基底细胞样型72U/mL)。在腔上皮型组中,CA15-3均值显著高于HER-2过表达型组和基底细胞样型组(P=0.017)。腔上皮型组中CA15-3值增高的发生率也较其他组显著升高(腔上皮型80.8%,HER-2过表达型55.6%,基底细胞样型68.6%;P=0.002)。另外,相比于其他脏器转移,骨转移者CA15-3值升高的发生率最高(P<0.05),其均值也最高(P<0.05)。结论:在腔上皮型转移性乳腺癌中,CA15-3值及其增高发生率均显著增加。这提示CA15-3检测对腔上皮亚型(ER阳性)乳腺癌复发转移的监测更具价值。

Objective：To retrospectively analyze the correlation between serum CA15-3 level and the molecular subtypes of metastatic breast cancer. Methods：A total of 268 patients diagnosed as having metastatic breast cancer in Hubei Cancer Hospital were recruited in this study. The serum CA15-3 level was examined by immunoradiometric assay, and the expression levels of ER （estrogen receptor）, PR （progesterone receptor） and HER-2 （human epidermal growth factor receptor-2） were detected by immunohistochemistry and FISH （fluorescence in situ hybridization）. The 268 patients were classified into 3 groups according to hormone receptor status：luminal subtype （ER-positive irrespective of HER-2-positive/negative and PR-positive/negative）, HER-2 over-expression subtype （ER-negative/PR-negative/HER-2-positive） and basal-like subtype （ER-negative/PR-negative/HER-2-negative）. The serum CA15-3 level and its elevation among freguency three subtypes of metastatic breast cancer were compared. Results：The average level of CA15-3 was significantly different among the three subtypes. The average level of CA15-3 in luminal subtype （96 U/mL） was significantly higher than those in HER-2 over-expression subtype （52 U/mL） and basal-like subtype （72 U/mL） （P = 0.017）. The frequency of elevation of serum CA15-3 level in patients with luminal subtype （80.8%） was much higher than those in patients with HER-2 over-expression subtype （55.6%） and basal-like subtype （68.6%） （P = 0.002）. Compared to other metastasis, the mean level of CA15-3 and the incidence of CA15-3 elevation were higher in patients with bone metastasis （P 〈 0.05）. Conclusion：The serum CA15-3 level in patients with luminal subtype of metastatic breast cancer is obviously increased, and the frequency of elevation of serum CA15-3 level is also significantly higher. It is suggested that the detection of serum CA15-3 is more valuable in the surveillance of recurrence and metastasis luminal subtype of ER-positive of breast cancer.