术前CEA和CA15-3对乳腺癌的临床应用价值

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。

Clinical value of preoperative CEA and CA15 -3 in breast cancer

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 lerll 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> 45 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.