TPS对转移性乳腺癌的临床应用价值

Significance of TPS monitoring in metastatic breast cancer

目的 探讨TPS对转移性乳腺癌的临床应用价值。方法 采用ELISA法测定 40例健康体检者及 6 2例乳腺癌患者 (其中 32例为治疗后转移复发 )的血清TPS、CA15 3、CEA及TPA水平 ,观察 11例转移性乳腺癌治疗后标志物的变化。结果 TPS对转移性乳腺癌敏感性为 81.3 % ,显著高于CA15 3及CEA(P <0 .0 1) ,CA15 3对转移性乳腺癌特异性为 95 .5 % ,显著高于TPS及TPA(P <0 .0 1) ,两者联合则有效性显著提高 (P <0 .0 1)。TPS对乳腺癌骨转移最为敏感 ,远处淋巴结转移的乳腺癌患者TPS水平最高。转移性乳腺癌治疗有效 (CR +PR +SD)各标记物与治疗前相比 ,均无显著性变化 (P >0 .0 1) ,治疗无效 (PD) ,TPS与TPA水平均显著升高 ,尤以TPS更甚 (P <0 .0 1)。结论 TPS是检出转移性乳腺癌最为敏感的标志物 ,尤其是骨转移的患者。TPS与CA15 3联合是监测转移性乳腺癌的最佳组合。TPS也是与预后有关的标志物 ,TPS水平升高表明病情进展 。

? Objective To determine the clinical value of detecting the levels of serum tissue polypeptide specific antigen(TPS) in monitoring metastatic breast carcinoma.Methods The levels of serum TPS CA15 3 CEA and TPA were detected by ELISA in 62 cases of breast carcinoma (32 metastatic breast cancer),40 cases of healthy adult.Results The sensitivity of TPS in metastatic breast cancer significantly higher than that of CA15 3 and CEA respectively (P<0.01).The specificity of CA15 3 in metastasis breast cancer significantly higher than those of TPS and TPA(P<0.01).The efficiency of TPS+CA15 3 significantly improved (P<0.01).TPS appeared to be especially sensitive in patients with metastases of bone and soft tissue as compared to patietns with visceral metastases.The levels of serum markers did not decrease significantly in patients with complete remission of partial remission or stable diseases(P<0.01),The levels of serum TPS and TPA increased significantly in patients with progressive diseases.Conclusions The combination of TPS and CA15 3 is preferable in monitoring metastatic breast carcinoma.TPS is a marker correlated with the prognosis.