血清CA15-3和CEA对转移性乳腺癌化疗疗效的预测作用  

Role of CA15-3 and CEA in predicting response during chemotherapy in metastatic breast cancer

作　　者：张丽[1] 佟仲生[1] 郝春芳[1] 何丽宏[1] 王忱[1] 李淑芬[1] 史业辉[1] 

机构地区：[1]天津医科大学附属肿瘤医院乳腺内科乳腺癌防治教育部重点实验室天津市肿瘤防治重点实验室,天津300060

出　　处：《实用肿瘤杂志》2010年第1期27-31,共5页Journal of Practical Oncology

摘　　要：目的分析转移性乳腺癌患者在接受化疗时及化疗后随访期间血清CA15-3和CEA的变化情况,探讨二者对化疗疗效的预测作用。方法治疗期间每2个周期以及随访期间每3月检测血清CA15-3和CEA,并通过影像学检查判断化疗疗效,分析血清标志物变化与化疗疗效的关系。结果疗效部分缓解(PR)的患者CA15-3及CEA在化疗期间明显降低(P<0.05);疾病稳定(SD)<1年组CA15-3和CEA出现明显升高,而SD≥1年组CA15-3在治疗第4周期时出现降低(P<0.05)。疾病进展(PD)患者血清CA15-3及CEA在治疗期间出现明显升高(P<0.05)。再次PD组患者CA15-3在进展前3月与进展时均有明显升高(P<0.05);CEA则在进展时出现有意义的升高。分析CA15-3升高组、CEA升高组、CA15-3及CEA同时升高组无进展生存情况,发现CA15-3和CEA同时升高组无进展生存率最低,肿瘤复发进展最快。结论CA15-3与CEA明显升高多可提示转移性乳腺癌化疗期间或随访期间的疾病进展,若出现明显降低则可能预示化疗疗效较好,二者同时检测,其结果较单一标志物准确度高。Objective To analyze the variation of CA15-3 and CEA during chemotherapy and follow-up in metastatic breast cancer,and to explore their predicting role to chemotherapy response.Methods CA15-3 and CEA were detected every two cycles during treatment,every 3 months during follow-up to judge the chemotherapy response through imageology examination.The relationship between the variation of CA15-3 and CEA and the chemotherapy response was analyzed.Results In patients with partial response（PR）,CA15-3 and CEA decreased during the treatment（P〈0.05）.In patients with stable disease（SD）〈1 year,CA15-3 and CEA showed significant increase（P〈0.05）.However,the CA15-3 levels in the patients with SD≥1 year decreased significantly after 4 cycles（P〈0.05）.In disease progression（PD） group significant increase of CA15-3 and CEA could be noted.In the patients with secondary PD,CA15-3 showed an obvious increase 3 months before progression and at the point of progression（P〈0.05）.CEA increased significantly at progression.Conclusions The obvious increase of CA15-3 and CEA can predict disease progression during chemotherapy or follow-up in the metastatic breast cancer patients.And the conspicuous decrease of CA15-3 and CEA usually shows a good result of treatment.It is more accurate to use both of CA15-3 and CEA than one.

关 键 词：乳腺肿瘤 肿瘤标记 生物学 癌胚抗原 CA15-3抗原 肿瘤转移 复发 预后 

分 类 号：R737.9[医药卫生—肿瘤]