乳腺癌血清ICTP、CA15-3水平与骨转移发生率的相关性研究  

Correlation between serum levels of ICTP and CA15-3 and bone metastasis in breast cancer

作　　者：王抒[1] 乔田奎[1] 张军宁[2] 

机构地区：[1]复旦大学附属金山医院肿瘤科,上海201508 [2]苏州大学附属第一医院放疗科,江苏苏州215006

出　　处：《中国癌症杂志》2012年第12期914-919,共6页China Oncology

摘　　要：背景与目的:Ⅰ型胶原羧基端肽(carboxyterminal telopeptide of typeⅠcollagen,ICTP)为骨吸收标志物,糖类抗原15-3(carbohydrate antigen 15-3,CA15-3)属于肿瘤相关性抗原。本研究通过对乳腺癌术后患者ICTP与CA15-3水平的定期检测,并随访观察,探讨ICTP与CA15-3水平与乳腺癌骨转移发生率的相关性。方法:对61例乳腺癌术后患者定期检测血清ICTP与CA15-3水平,术后第1年每个月检测1次,第2年每2个月1次,第3年每3个月1次。观察临床分期与血清ICTP与CA15-3阳性率的关系,评估联合检测血清ICTP、CA15-3对乳腺癌骨转移的诊断价值。结果:临床分期Ⅰ、Ⅱ期ICTP与CA15-3阳性升高率低,Ⅲ、Ⅳ期阳性升高率明显增高,各分期比较差异有统计学意义(P<0.05)。随着血清ICTP、CA15-3水平升高,各个区段骨转移发生率之间差异有统计学意义(P<0.01);两者均与骨转移发生有良好相关性(P<0.01),且两者之间呈中度相关。61例中有27例ICTP、CA15-3均升高并呈阳性,其中有21例出现临床骨转移症状,占77.78%;在11例ICTP与CA15-3均为阴性的术后患者中,有1例出现临床骨转移症状及相关证据,占9.01%;两者相比差异有统计学意义(P<0.01)。ICTP与CA15-3联合检测对乳腺癌骨转移诊断的敏感性、特异性及阳性预测值、阴性预测值均高于单独检测。结论:定期检测乳腺癌术后患者血清ICTP与CA15-3,对预测骨转移有重要的临床应用价值。Background and purpose： Carboxyterminal telopeptide of type Ⅰ collagen （ICTP） is one of the bone resorption markers. Carbohydrate antigen 15-3 （CA15-3） belongs to the tumor-associated antigens. This study aimed to explore the correlation between the levels of ICTP and CA 15-3 and bone metastasis in breast cancer through periodic tests of ICTP and CA15-3 serum levels and follow-up observations in post-operative breast cancer patients. Methods： Periodic tests were performed to detect the serum levels of ICTP and CA15-3 in 61 post-operative breast cancer patients. The tests were carried out once every month in the first year after surgery, once every two months in the second year, and once every three months in the third year. The patients were assigned to the normal group or the elevated group based on the levels of serum ICTP and CA15-3, and observed and followed up for a period of two years on incidence of bone metastasis. Results： The increase in the positive rates of ICTP and CA 15-3 during clinical stages Ⅰ and Ⅱ were low, and increased significantly during clinical stages Ⅲ and IV. The difference was significant （P〈0.05）. As serum levels of ICTP and CA15-3 increased, significant difference existed in the incidences of bone metastasis during different phases （P〈0.01）. Levels oflCTP and CA15-3 correlated well to the bone metastasis （P〈0.01）. Levels of ICTP correlated well to CA15-3. A total number of 27 of the 61 post-operative patients showed increased positive rates in both ICTP and CA15-3, 21 patients （77.78%） developed clinical symptoms of bone metastasis,Ⅰ of the 11 patients （9.01%） with both positive ICTP and CA15-3 rates experienced clinical symptoms of bone metastasis with supporting evidence. Significant difference existed between the two groups（P〈0.01）. Joint tests for ICTP and CA15-3 renderedhigher diagnostic sensitivity, specificity, positive predictive values, and negative predictive values than singular tests. Conclusion： Periodic tests of

关 键 词：Ⅰ型胶原羧基端肽 糖类抗原15—3 乳腺癌 骨转移 

分 类 号：R737.9[医药卫生—肿瘤]