术前CEA和CA15-3对乳腺癌的临床应用价值

摘要

Objective: To investigate the value of preoperative carbohydrate carcinoembryonic antigen (CEA) and antigen 15-3 (CA 15-3) in the early diagnosis of breast cancer and the association between tumor markers and clinicopathological parameters. Methods: We retrospectively studied CEA.CA15 -3 and clinical pathological factors of 1028 breast cancer patients diagnosed between 2000 and 2005. Results; Increased CEA and CA 15-3 concentrations were found in 9. 5% and 15. 3% of the patients, respectively, and 1 or both tumor markers were only increased in 20. 9%. Tumor marker measurements can contribute usefully to early detection the site of distant metastatic disease , 1 or both tumor markers concentrations were increased in liver, bone and lung distant metastatic disease with 86.7% ,90.9% ,45.5% (P =0.030) .respectively. The sensitivity of CEA and CA 15 -3 concentrations of detection of metastatic site was no significant different (all P > 0. 05). Increased lerl in each tumor marker correlated with clinical stage, larger tumor sizes and nodal involvement (all P <0. 001). Increased CEA concentrations were significantly correlated with age > 4 5 years old , postmenopausal, ER — negative , PR - negative , Her - 2 positive ( all P < 0. 05 ) . Conclusion: Preoperative CEA and CA15 - 3 in the early diagnosis of breast cancer were lack of sensitivity, CEA and CA15 —3 can be used as important prognostic factors in breast cancer.%目的:探讨术前CEA和CA15 -3对乳腺癌早期诊断的价值及其与临床病理因素的相关性.方法:回顾性分析2000年-2005年1028例乳腺癌患者的CEA、CA15 -3水平以及与临床病理因素的关系.结果:CEA、CA15 -3联合检测、CA15 -3及CEA单独检测对乳腺癌的早期诊断敏感性均低,分别为20.9％、15.3％、9.5％；CA15-3和CEA联合检测在肝、骨和肺转移的阳性率则分别为86.7％、90.9％、45.5％(P=0.030),CA15 -3、CEA单独检测对转移病灶的敏感性无差异(P均＞0.05).CEA、CA15 -3单独检测及CEA、CA15 -3联合检测的阳性率与乳腺癌的临床分期、T分期、N分期呈正相关性,(P均＜0.001).CEA单独检测的阳性率与年龄＞45岁、绝经后、ER阴性、PR阴性、Her2阳性有显著相关性(P均＜0.05)；除CEA、CA15 -3联合检测的阳性率与Her2阳性呈正相关,联合检测及CA15 -3单独检测与其他因素无相关性.结论:术前CEA和CA15 -3对乳腺癌的早期诊断缺乏敏感性,但可作为预测预后的重要指标.