血清CA153检测对复发性乳腺癌的临床价值

Clinical value of serum CA153 assay in the patients with recurrent breast carcinoma

目的 观察血清CA153测定在复发性乳腺癌中的临床意义。方法 采用荧光免疫法测定98例乳腺癌复发后血清CA153和CEA值,并与复发前3个月CA153随访结果进行比较分析,观察化疗后CA153变化,以CA153>33 U/ml为CA153升高阳性。CEA>10μg/L为CEA升高阳性。结果98例患者中,临床发现复发前3个月CA153升高60例,占61.2％;复发后CA153升高80例,占81.6％;CEA升高61例,占62.2％。CA153升高病例化疗2周期后,印例化疗有效组中CA153下降至正常或未降至正常但其数值下降超过50％共56例,占93.3％;20例化疗无效组中仅4例,占20.0%,两者差异有显著性(P<0.01)。多脏器转移病例血清CA153值为150.1+51.8 U/ml,局部或单一脏器转移CA153值为50.2+34.0 U/ml,两者差异有显著性(P<0.01)。结论CA153可作为乳腺癌复发转移早期诊断指标,比CEA敏感性高,可作为化疗效果观察的辅助指标,其变化可反映临床疗效,CA153绝对值可反映病期及病情进展。

Objective To evaluate the clinical value of serum CA153 in the patients with recurrent breast carcinoma.Methods Serum CA153 and CEA were determined using fluorescence immunoassay in 98 patients with recurrent breast carcinoma. Results Serum CA153 was found elevated in 61.2% of the patients 3 months before tumor relapse and 81.6% after clinical recurrence. The CA153 level in the patients with more than one organ tumor metastasis was higher than that in the patients with only one organ metastasis( P < 0.01) .The CA153 became normal or much lower than before after being given 2 cycles of chemotherapy in 93.3% of the patients with elevated serum CA153 when they got CR or PR and in 20.0% when they got SD or PD. Serum CEA was found elevated in 62.2% of the patients. Conclusions Serum CA153 assay is very useful to the early diagnosis of the recurrent breast carcinoma and the judgement of the chemotherapy efficacy. It also reflects the disease stage.