乳腺癌患者血清肿瘤标志物水平与预后关系

Relationship between expressions of serum tumor biomarkers and prognosis of breast cancer

目的探讨血清肿瘤标志物癌胚抗原(CEA)、糖类抗原153(CA153)、组织多肽特异性抗原(TPS)与乳腺癌预后的关系。方法选择经病理诊断的乳腺癌原发病例患者187例,收集临床病例资料及检测清肿瘤标志物CEA、CA153、TPS,并对病例进行随访,分析乳腺癌患者CEA、CA153、TPS的表达与乳腺癌临床病理因素及预后的关系。结果乳腺癌患者TNM分期、淋巴结有无转移对乳腺癌患者血清CEA、CA153阳性率有影响(P<0.05),乳腺癌患者TNM分期、淋巴结有无转移、分化程度对乳腺癌患者血清TPS阳性率有影响(P<0.05);术前CEA、CA153、TPS表达单阳性或三阳性病例的生存时间明显缩短(均P<0.05)。结论乳腺癌术前血清CEA、CA153和TPS水平升高可预测预后不良,血清CA153、血清TPS和分化程度可作为预测乳腺癌预后的因素。

Objective To explore associations between carcinoembryonic antigen（CEA）, carbohydrate antigen 153 （CA153）, tissue polypeptide specific antigen （TPS） and clinical outcomes in breast cancer patients. Methods A total of 187 female breast cancer patients were selected and followed up. The data on clinical/pathological factors and clinic outcomes were collected and serum CEA, CA153, and TPS were measured among the patients. The relationships between CEA, CA153, TPS level and clinical/pathological factors and survival of the patients were analyzed. Results There were significant differences in positive rates of serum CEA and CA153 among the patients with different tumor-node-metastasis （TNM） stages and between the patients with and without lymph node metastasis （ all P 〈 0. 05 ）. There were significant differences in the positive rate of TPS among the patients with different TNM stage, lymph node metastasis status, and degree of tumor cell differentiation（ all P 〈 0.05 ）. The survival time of the patients with either positive result of CEA/ CA153/TPS or the combination of the three indicators was significantly less than that of the patients with negative result of the indicators （ all P 〈 0.05 ）. Cox regression analyses showed that the expression of CA153 （ risk ratio ERR ] = 3.462 ）, TPS （RR =2. 193） and degree of cell tumor differentiation（RR =4. 215） were independent risk factors for poor prognosis of breast cancer（ all P 〈 0. 05 ）. Conclusion High serum level of CEA, CA153 and TSP may predict poor outcome for breast cancer patients. CA153 ,TPS and amaor cell differentiation degree may serve as prognosis factors for breast cancer.