血清CA15-3在非病理性完全缓解新辅助化疗乳腺癌患者中的表达及临床意义

Expression and Clinical Significance of Serum CA15-3 in Breast Cancer Patients with Non-pCR after Neoadjuvant Chemotherapy

目的探讨血清癌抗原15-3(CA15-3)在非病理性完全缓解(non-pCR)新辅助化疗(NAC)乳腺癌患者中的表达及临床意义。方法选取2011年1月—2013年12月就诊的原发性浸润性乳腺癌123例作为研究对象,比较病理性完全缓解(pCR)和non-pCR NAC乳腺癌患者及CA15-3高表达和低表达non-pCR NAC乳腺癌患者一般资料和病理特征,探讨影响NAC乳腺癌患者non-pCR的病理特征及CA15-3高表达和低表达non-pCR NAC乳腺癌患者生存情况。结果接受NAC原发性浸润性乳腺癌123例中,pCR 27例,non-pCR 96例。non-pCR NAC乳腺癌患者TNM分期Ⅲ或Ⅳ期、雌激素受体(ER)阴性及CA15-3高表达所占比例高于pCR NAC乳腺癌患者,差异有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,CA15-3高表达与NAC乳腺癌患者non-pCR有关(P<0.01)。non-pCR NAC乳腺癌患者治疗前血清CA15-3高表达52例,低表达44例。血清CA15-3高表达non-pCR NAC乳腺癌患者Ki-67高表达所占比例高于血清CA15-3低表达non-pCR NAC乳腺癌患者,差异有统计学意义(P<0.05)。Kaplan-Meier法生存曲线分析结果显示,5年生存率CA15-3高表达低于CA15-3低表达non-pCR NAC乳腺癌患者,差异有统计学意义(P<0.01)。结论血清CA15-3在non-pCR NAC乳腺癌患者中呈高表达,且其对NAC乳腺癌患者non-pCR及预后有一定预测作用。

Objective To investigate expression and clinical significance of serum cancer antigen 15-3(CA15-3)in breast cancer patients with non-pathological complete remission(non-pCR)after neoadjuvant chemotherapy(NAC).Methods A total of 123 patients with primary invasive breast cancer during January 2011 and December 2013 were selected as research subjects.General data and pathological characteristics were compared among breast cancer patients with pathological complete remission(pCR)and non-pCR after NAC,and those non-pCR patients with high and low expressions of CA15-3 after NAC,and pathological characteristics affected non-pCR patients with breast cancer after NAC,and survival conditions of non-pCR breast cancer patients with high and low expressions of CA15-3 after NAC were investigated.Results Among 123 patients with primary invasive breast cancer who had received NAC,there were 27 with pCR and 96 with non-pCR.Proportions of TNM stageⅢorⅣ,negative estrogen receptor(ER)and high expression of CA15-3 in breast cancer patients with non-PCR after NAC were significantly higher than those in breast cancer patients with pCR after NAC(P<0.01).Multivariate logistic regression analysis showed that the high expression of CA15-3 was related to non-pCR breast cancer patients after NAC(P<0.01).Before treatment,52 with high expression and 44 with low expression of serum CA15-3 in breast cancer patients with non-pCR after NAC.Proportion of high-expressed Ki67 in non-pCR breast cancer patients with high-expressed serum CA15-3 after NAC was larger than that in non-pCR breast cancer patients with low-expressed serum CA15-3 after NAC(P<0.05).Based on Kaplan-Meier method,survival curve analysis showed that the 5-years survival rate in high-expressed CA15-3 patients was significantly lower than that in low-expressed CA15-3 patients in breast cancer patients with non-pCR after NAC(P<0.01).Conclusion Serum CA15-3 is highly expressed in breast cancer patients with non-pCR after NAC,which plays a certain role in prediction of non-pCR and prognosis of patients after NAC.