【摘要】 目的:分析乳腺癌脑转移患者的临床及病理资料,探讨脑转移时血清肿瘤标志CEA、CA125和CA153水平与临床病理特征和预后的相关性。方法:回顾性分析1998-04-01-2011-05-31河南省肿瘤医院及郑州大学第一附属医院收治的83例乳腺癌脑转移患者的资料,分析血清中CEA、CA125和CA153表达水平与临床病理特征的关系及预后因素分析。结果:全组中位生存时间9.6个月(0.3～32.6个月),1年生存率为41.0%,2年生存率为7.2%。血清CEA、CA125和CA153的阳性表达率分别为43.4%(36/83)、44.6%(46/83)和51.8%(43/83)。高血清CA153水平与多发脑转移有关,P<0.05;高血清CA125水平与多发脑转移、PS评分及伴发颅外转移均有关,P<0.05。血清CEA≤5ng/mL者比CEA>5ng/mL者预后好,中位生存时间分别为13.1个月和6.0个月,P=0.000;与CA125≤35U/mL相比,CA125>35U/mL者预后差,中位生存时间分别为16.8个月和6.9个月,P=0.001。多因素分析显示,PS评分、脑转移的治疗方式和CEA表达水平是影响乳腺癌脑转移患者预后的独立因素,差异均有统计学意义,P<0.05。结论:脑转移时血清CA125和CA153的表达水平与乳腺癌脑转移患者的临床病理特征有关,CEA和CA125的表达水平与预后有关,CEA是影响乳腺癌脑转移患者预后的独立预后因素,高CEA表达水平者预后较差。更多还原

【Abstract】 OBJECTIVE:To explore the relationship between the clinical characteristics and serum CEA,CA125 and CA153 levels,and identify the prognostic factors in patients with brain metastases from breast cancer.METHODS:A total of 83 patients with brain metastases from breast cancer diagnosed at Henan Cancer Hospital and First Affiliated Hospital of Zhengzhou University from 04-01-1998 to 05-31-2011 were retrospectively analyzed in this study to determine the prognostic factors that affected clinical outcome.RESULTS:The median survival time was 9.6 months(0.3-32.6 months).The one-and two-year survival rates of the patients were 41.0% and 7.2%,respectively.Higher serum CA153 expression level was significantly associated with multiple brain metastases(P<0.05).The expression rates of CEA,CA125 and CA153 were 43.4%(36/83),44.6%(46/83) and 51.8%(43/83).Increased CA125 was related with multiple brain metastases,performance status score and other organ of metastases(P<0.05).Overall survival as significantly shorter among patients with elevated serum CEA(median survival 13.1 months vs 6.0 months,P=0.000) or CA125(median survival 16.8 months vs 6.9 months,P=0.001).Finally,multivariate Cox analysis demonstrated that performance status score,serum CEA and treatment styles were the independent prognostic factors for overall survival(P<0.05).CONCLUSIONS:Higher expression of serum CA153 or CA125 at brain metastases is closely correlated with clinicopathological characteristics.Expression values of CEA or CA125 is significantly associated with overall survival.CEA expression level can be used as an independent prognostic factor in patients with brain metastases from breast cancer.The prognosis is poorer in these patients with higher CEA expression level.更多还原