早期乳腺癌患者术前血清癌胚抗原和CA15-3水平及其与病理学特征的关系

Serum levels of carcino-embryonic antigen and CA15-3 in patients with early stage breast cancer ;before surgery and their correlation with pathological features

目的：探讨早期浸润性乳腺癌患者术前血清癌胚抗原（CEA）和糖类抗原CA15-3水平的变化及其与病理学参数的相关性。方法应用电化学发光免疫分析（ECLI）技术检测223例早期浸润性乳腺癌患者、109例良性病变患者及30名健康对照的血清CEA和CA15-3水平，免疫组织化学和荧光原位杂交法（FISH）检测雌激素受体（ER）、孕激素受体（PR）、HER2等病理学指标。分析乳腺癌血清CEA、CA15-3水平与病理学参数的相关性。结果乳腺癌组患者的血清CA15-3和CEA水平分别为（22.27，15.11）U／ml、（5.03，0.49）μg／L，均高于良性病变组患者（14.13，3.04）U／ml和（2.72，0.11）μg／L，差异均有统计学意义（均P〈0.05）。组织学Ⅲ级患者的CEA水平为（6.34，0.93）μg／L，明显高于Ⅰ-Ⅱ级的（4.23，0.50）μg／L，差异有统计学意义（P〈0.05）。T1期肿瘤CA15-3水平为（19.26，15.08）U／ml， T2期肿瘤CA15-3水平为（28.73，11.53）U／ml，差异有统计学意义（P〈0.05）。不同的组织学类型、病理分期、淋巴结状态、ER、PR、HER2等病理特征间，血清CEA、CA15-3水平差异均无统计学意义（均P〉0.05）。乳腺癌组CEA、CA15-3阳性率分别为13.5%、26.5%，均高于良性病变组的3.7%和1.8%，差异有统计学意义（P〈0.05）。30例健康对照组中CEA、CA15-3无一例阳性。乳腺癌组CEA和CA15-3二者联合检测敏感度均为9.4%，良性病变组敏感度为0，差异均有统计学意义（均P〈0.05）。结论患者血清中CEA和CA15-3水平变化为乳腺癌早期诊断、病理分期、预后判断和疗效监测提供有效的临床依据。

Objective To detect and analyze the levels of preoperative serum carcino-embryonic antigen （CEA） and CA15-3 in early invasive breast cancer patients and their correlation with pathological parameters. Methods Electrochemical luminescence immunoassay （ECLI） technology was used to detect serum levels of CEA and CA15-3 in 223 cases of early invasive breast cancer patients, 109 patients with benign lesions, and 30 cases of heath control. Immunohistochemical （IHC） and fluorescence in situ hybridization （FISH） were used to detect the estrogen receptors （ER）, progesterone recepter （PR）, and its HER-2 pathological indicators.Besides, the correlation of serum CA15-3, CEA levels and pathological parameters was analyzed. Results The serum CA15-3 and CEA levels of Breast cancer patients [（22.27,15.11） U/ml, （5.03± 0.49） μg/L] were significantly higher than that of patients in benign lesion group [（14.13,3.04） U/ml, （2.72, 0.11） μg/L] （P〈 0.05）. CEA level of patients with histological grade Ⅲ was （6.34 ,0.93） μg/L, significantly higher than the level Ⅰ-Ⅱ （4.23,0.50） μg/L （P〈 0.05）. CA15-3 level was （19.26,15.08） U/ml in T1 tumors, and CA15-3 level was （28.73 ,11.53） U/ml in T2 tumors （P〈0.05）. The serum levels of CEA and CA15-3 between different histology, pathologic stage, lymph node status, ER, PR, HER-2, pathological characteristics had no significant difference （P〉0.05）. CEA positive rate of breast cancer group was significantly higher than that of benign lesions（13.5%vs. 3.7%, 26.5%vs. 1.8%, P〈0.05）. 30 cases of normal control group had no positive one. The joint monitoring sensitivity of CEA and CA15-3 breast cancer group was 9.4 %, the sensitivity was 0 in benign lesion group. There was significant difference （P 〈 0.05）. Conclusion The changes of Serum CA15-3 and CEA levels in breast cancer patients can be considered as the judgment standard for early diagnosis, pathological staging, prognosis and clinical effect monitoring.