【摘要】 目的探讨血清CA153,CEA,TPS,CA125联合检测在监测乳腺癌患者复发转移中的意义。方法采用化学发光法检测1000例乳腺癌患者和245例良性疾病者的血清CA153,CEA,TPS,CA125水平,根据患者是否进行手术和术后有无转移分组,分别比较4项标志物和联合检测的敏感性。结果乳腺癌术前患者与乳腺癌术后发生转移患者的CEA,CA153,TPS水平的差异有统计学意义(P<0.001);而术后发生转移的患者与术后无转移患者的CEA,CA153,TPS,CA125水平的差异有统计学意义(P<0.001)。单个监测4项标志物,其敏感性均在术后转移患者中提高,与术前患者、术后无转移患者比较,其差异有统计学意义(P<0.05)。采用4项肿瘤标志物的联合检测,对术前患者的敏感性提高到56.72%,术后转移患者的敏感性提高到94.68%。CA153和CEA水平、TPS和CEA水平在乳腺癌患者中的分布有明显的相关性,r分别为0.410,0.396(P=0.0001)。结论分别检测四项标志物,其对术后转移患者的敏感性均更高,而联合检测对监测乳腺癌进展期、复发和转移有重要的指导意义。更多还原

【Abstract】 Objective To study the usefulness of combined detection of 4 tumor markers in patients with recrudescent and metastatic breast cancer. Methods The serum levels of CA153, CEA, TPS and CA125 were determined by chemiluminescence immunoassay. A total of 1245 subjects entered the study. Sensitivities of the tests were evaluated in 1 000 patients with breast cancer (102 preoperative patients and 898 postoperative patients) and 245 with benign breast disease. Results The serum levels of CA153, CEA and TPS were significantly elevated in preoperative patients compared with metastatic patients (P<0.001). The serum levels of CA153, CEA, TPS and CA125 were significantly elevated in metastatic patients compared with non-metastatic patients (P<0.001). The sensitivity of the 4 tumor markers were significantly elevated in metastatic patients compared with preoperative and postoperative non-metastatic patients (P<0.05). The sensitivity of combined detection of the 4 tumor markers were 56.72% and 94.68% in preoperative patients and metastatic patients, respectively. The CEA elevation was strongly correlated with CA153 and TPS levels (all P=0.000 1, r=0.410 and 0.396, respectively). Conclusion Combined detection of the 4 tumor markers may play a guiding role in post-therapeutic monitoring of breast cancer in progressive, recrudescent and metastatic patients.更多还原