血清肿瘤标记物β_2微球蛋白、癌胚抗原、CA153和CA125检测对乳腺癌临床实践的意义探讨  

Significance of tumor markers including β2-microglobulin,carcino-embryonic antigen,CA153 and CA125 in clinical practice for breast cancer

作　　者：华彬[1] 阿合提别克.塔布斯 陆旭[1] 肖文政[1] 韩靖云[3] 李波[1] 

机构地区：[1]北京医院乳腺疾病中心,北京100730 [2]新疆医科大学第二附属医院普外科,乌鲁木齐830063 [3]北京医院检验科

出　　处：《中华乳腺病杂志（电子版）》2012年第3期10-13,共4页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的检测乳腺癌患者外周血中β2微球蛋白(β2-MG)、癌胚抗原(CEA)、CA153、CA125水平,以探讨外周血β2-MG、CEA、CA153、CA125在乳腺癌临床实践中的作用。方法对140例乳腺癌患者及144例健康体检者应用免疫散射比浊法检测外周血β2-MG,用化学发光法检测外周血CEA、CA153、CA125的水平,数据统计用Kruskal-Wallis检验、Chi-square检验和Wilcoxon秩和检验。结果乳腺癌患者外周血β2-MG和CEA的检测值分别为1.8(1.5～2.2)mg/L和1.7(1.2～2.4)ng/ml,高于健康对照组[1.5(1.3～1.8)mg/L,1.2(0.9～1.9)ng/ml,P<0.05],且阳性率高于健康人群(P<0.05);以β2-MG检测为基础,联合检测未增加诊断的敏感性(P>0.05);以临床分期为参照指标,CA153在Ⅲ期患者的检测值明显高于Ⅰ期和Ⅱ期患者(P<0.05)。乳腺癌患者术后β2-MG、CEA、CA153检测均有下降,与术前相比差异有统计学意义(P<0.05)。结论以β2-MG为基础的联合诊断对乳腺癌诊断敏感性未见明显增加;血清CA153检测水平对乳腺癌预后有一定的预测作用;β2-MG、CEA和CA153对乳腺癌术后随访有一定临床意义。Objective To detect the levels of serum tumor marker β2-microglobulin （ β2-MG）, CEA, CA153 and CA125 so as to evaluate their clinical significance in clinical treatment of breast cancer. Methods The β2-MG level in peripheral blood was detected by nephelometry and the CEA, CA153 and CA125 levels in peripheral blood were determined by chemiluminescence method. Statistical analysis was performed using Kruskal-Wallis test, Chi-square test or Wilcoxon test. Results The β2-MG and CEA levels in peripheral blood were 1.8 （ 1.5-2. 2） mg/L and 1.7 （ 1.2-2.4 ） ng/ml in breast cancer patients respectively, which were higher than those of healthy controls [ （ 1.5 （ 1.3-1.8 ） mg/L, 1.2 （0. 9-1.9） ng/ml, P〈0. 051. The positive rate in breast cancer patients was higher than that in healthy control. On the basis of β2-MG test, combined tests of more than one tumor marker could not increase the sensitivity （P〉0. 05 ）. According to clinical-pathologic stage, the CA153 level was statistically higher in stage Ⅲ patients than that in stageⅠor Ⅱ （P〈0.05） ; After operation, the β2-MG, CEA and CA153 levels in peripheral blood in breast cancer patients were significantly lower than the preoperative levels （ P〈0. 05 ）. Conclusions Based on the level of β2-MG in peripheral blood, combined test cannot increase the sensitivity of diagnosis. The CA153 level may be useful in predicting the prognosis. There are significant differences in the levels of tumor markers between preoperative and postoperative breast cancer patients, which imply the importance of tumor markers in follow-up.

关 键 词：乳腺肿瘤 诊断 预后 Β2-微球蛋白 癌胚抗原 CA153 CA125 

分 类 号：R737.9[医药卫生—肿瘤]