肿瘤标志物在乳腺癌术后复发转移监测中的应用价值

Clinical value of tumor marker in the postoperative recidivation and metastasis of breast cancer

目的:探讨肿瘤标志物在乳腺癌术后复发转移监测中的应用价值。方法:用多肿瘤标志物系统对121例乳腺癌术后患者(其中包括49例术后复发转移患者及72例术后无复发转移患者)血清样本的12项肿瘤标志物(CA19-9、NSE、CEA、CA242、Ferritin、β-HCG、AFP、F-PSA、PSA、CA125、HGH、CA15-3)的表达水平进行测定,Logistic回归分析与ROC曲线法评价肿瘤标志物在复发转移中的应用价值。结果:乳腺癌术后复发转移组与无复发转移组的蛋白芯片阳性率差异显著(P<0.05)。与无复发组测定结果比较,CA19-9、CEA、Ferritin、CA125、CA15-3的表达水平及阳性率差异具有统计学意义(P<0.05)。Logistic回归分析筛选CEA、CA125、CA15-3为监测乳腺癌术后复发转移的有效指标,ROC曲线法三者曲线下面积为0.813、0.808、0.772。CEA、CA125、CA15-3联合监测乳腺癌术后复发转移的敏感性与芯片相同(81.6%),特异性与准确性高于芯片(95.8%vs 92.7%,90.1%vs 87.6%)。结论:CEA、CA125、CA153联合检测可能作为临床监测乳腺癌术后复发转移优化方案。

Objective ：To explore the clinical value of tumor marker in the postoperative recidivation and metasta-sis of breast cancer. Methods：The serum levels of 12 tumor markers, including CA19 -9, NSE, CEA, Ferritin, β - HCG, AFP, F - PSA, PSA, CA125, HGH and CA15 - 3, were detected in 121 postoperative patients with breast cancer （ 49 patients with recurrence and metastasis vs 72 patients without recurrence and metastasis ） by multiple tumor marker protein chip to evaluate the application of tumor marker in the postoperative recidivation and metastasis by lo- gistics regression and ROC curve. Results：Recurrence and metastasis group had significantly higher rate than that of none of recurrence and metastasis group （ P 〈 0.05 ）. Significant differences were detected in the positive rate and ser-um levels CA19 - 9, CEA, Ferritin, CA125, CA15 - 3 between two groups （ P 〈 0.05 ）. CEA, CA125, CA15 - 3 were selected as the effective index in the postoperative recidivation and metastasis of breast cancer by logistics regression. The corresponding areas under curve were 0. 813,0. 808,0. 772 respectively by ROC curve. Combination of CEA, CAl25 ,CA15 -3 in the monitoring of postoperative recidivation and metastasis of breast cancer had same sensitivity as chip,higher specificity and accuracy than chip. Conclusion： Combination of CEA, CA125, CA15 - 3 may be the e-conomical and effective method in the monitoring of postoperative recidivation and metastasis of breast cancer.