血清VEGF监测术后复发转移性乳腺癌的临床意义

探讨术后复发转移性乳腺癌患者血清VEGF表达及其临床意义.用ELISA检测50例复发转移性乳腺癌,20例原发性乳腺癌,20例乳腺良性疾病及15例健康女性血清VEGF的浓度.结果:复发转移组血清VEGF浓度高于原发组(P＜0.05)、良性疾病及健康对照组(P＜0.01).血清VEGF表达阳性率高于CEA、CA15-3( P＜0.05),而与CEA、CA15-3联合表达差异无显著性(P＞0.05),与复发转移部位、原肿瘤病理类型、腋淋巴结转移状况、ER、PR、HER-2表达及月经状况无关(P＞0.05).结论:复发转移组血清VEGF表达水平明显升高.单项检测VEGF优于CEA、CA15-3,与CEA和CA15-3联合检测表达相似.血清VEGF有望作为乳腺癌复发转移的一项监测指标.     

CA125和CA15-3及CEA对乳腺肿瘤的鉴别诊断及联合检测效果分析

探讨CA125、CA15-3、CEA单独及联合检测对乳腺肿瘤鉴别诊断的应用价值.选取2018年3月—2019年3月肇庆市第一人民医院收治的乳腺癌患者65例作为恶性组,另取同期40例乳腺良性病变患者作为良性组,35例健康女性作为对照组,采用电化学发光法检测各组血清糖类抗原(CA125、CA15-3)、癌胚抗原(CEA)水...     

微小核糖核酸34a、糖类抗原15-3和糖类抗原125联合检测在乳腺癌复发转移监测中的价值

目的:探讨血清微小核糖核酸-34a(miR-34a)、癌抗原15-3(CA15-3)和癌抗原125(CA125)联合检测在乳腺癌复发转移监测中的价值。方法:根据患者影像学及病理组织学检查将2016年1月至2020年12月武汉科技大学附属普仁医院诊治的96例女性乳腺癌患者分为复发转移组(39例)与未复发转移组(57例),...     

结直肠癌患者术前CEA、CA19-9浓度与临床病理特征及预后的关系

目的:探讨结直肠癌患者术前CEA、CA19-9浓度与临床病理特征及预后的关系。方法:收集2007年1月—2008年7月收治并行根治性手术的356例结直肠癌患者的临床病理资料,分析血清CEA、CA19-9与临床病理特征及生存率的关系。结果:单因素分析结果显示,血清CEA浓度升高与肿瘤浸润深度、淋巴结转移、病理类型、肝转移、周围脏器受累有关(均P<0.05);血清CA19-9浓度升高与肿瘤浸润深度、腹膜转移、肝转移有关(均P<0.05)。生存分析结果显示,血清CEA浓度升高患者生存率低于血清CEA浓度正常患者(P<0.05);血清CA19-9浓度升高患者与血清CA19-9浓度正常患者生存率差异无统计学意义(P>0.05);血清CEA、CA19-9浓度同时升高患者与血清CEA升高或血清CA19-9升高患者生存率差异无统计学意义(均P>0.05),但明显低于血清CEA、CA19-9均正常患者(P<0.05)。结论:血清CEA、CA19-9浓度同时升高可能是结直肠癌的晚期事件,提示患者预后不良。     

肿瘤标志物CEA、CA15-3和CA125的表达与乳腺癌术后转移相关性研究

目的探讨联合检测肿瘤标志物CEA、CA15-3和CA125手术前后变化与乳腺癌术后转移的相关性。方法收集整理2015年1月至2019年12月期间收治的乳腺癌行改良根治术病人资料,术后转移者作为研究组,同期无转移者入对照组,两组分别65例。统计其手术前后肿瘤标志物CEA、CA15-3和CA125结果,分析联合检测在预测肿瘤转移中的价值。结果观察组较对照组3种肿瘤标志物检测结果显著升高,差异具有统计学意义。3种肿瘤标志物单独用于预测转移性乳腺癌(Metastatic breast cancer,MBC)时CEA敏感性最高,其次是CA15-3,而敏感性则为CA125最高。三者中两两联合检测结果表明,对于预测MBC效果敏感性较好的是CEA+CA15-3(66.46%);特异性较好的是CA125+CA15-3组合(92.37%);三者联合用于预测MBC敏感性和特异性相加之和在各组中最优。结论肿瘤标志物CEA、CA15-3和CA125三者联合检测对于预测MBC具有一定的临床价值。     

血清糖类抗原125对胃癌腹膜转移及其预后的预测价值

目的：探讨胃癌患者血清糖类抗原125（CA125）水平对腹膜转移的预测价值及其与预后的关系。方法回顾性收集山东大学齐鲁医院普通外科2003年3月至2008年9月间收治的1285例胃癌患者临床资料,分析血清 CA125水平诊断胃癌腹膜转移的敏感性、特异性及准确性;并比较CA125正常（小于或等于35μg/L）与CA125升高（大于35μg/L）患者的临床病理资料及生存情况。结果血清 CA125在诊断腹膜转移的特异性为96．0％（1011/1053）,敏感性为13．8％（32/232）,准确性为81．2％（1043/1285）。血清CA125升高患者腹膜转移发生率显著高于CA125正常者[43．2％（32/74）比16．5％（200/1211）,P＜0．01];CA125升高是腹膜转移的独立预测因素（RR＝3．475,95％ CI：2．124～5．685）。血清CA125升高患者术后5年总生存率为13．5％,显著低于CA125正常者的49．8％（P＜0．01）;CA125升高是胃癌患者的独立预后因素（HR＝2．049,95％CI：1．355～2．873）。结论血清CA125水平可有效预测胃癌患者腹膜转移及预后情况,建议胃癌患者应常规检查血清CA125水平。     

术前血清CA125预测胃癌腹膜转移的单中心大样本临床研究

目的:探讨术前血清CA125等肿瘤标志物对胃癌腹膜转移的预测价值。方法:术前检测1 348例胃癌病人的血清CA125、CA19-9、CA72-4和CEA水平,其检测值与临床病理参数作分析。结果:受试者工作特征(ROC)分析显示,血清CA125对胃癌腹膜转移术前判断的准确率最高,CA125、CA19-9、CA72-4和CEA的ROC曲线下面积分别为0.85、0.61、0.71和0.43。ROC分析进一步显示,血清CA125预测腹水的诊断价值较高(ROC曲线下面积为0.97),并且血清CA125水平与腹水量密切相关(r=0.686,P0.001)。以35 u/mL作为血清CA125的临界值,血清CA125预测胃癌腹膜转移的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为43.6%(41/94)、96.5%(1210/1254)、48.2%(41/85)、95.8%(1 210/1 263)和92.8%(1 251/1 348)。此外,血清CA125对伴有腹水胃癌腹膜转移的灵敏度较无腹水的胃癌腹膜转移显著增高(79.4%比23.3%,P0.001)。结论:术前血清CA125对胃癌腹膜转移的预测价值较高,且血清CA125水平与腹水量密切相关。     

结直肠癌卵巢转移的检测及外科干预分析

目的本研究旨在通过回顾性分析患者临床病理资料, 对结直肠癌卵巢转移的血清学检测指标和不同手术方式(单侧/对侧切除)的进行分析及探讨。方法回顾性分析2006年1月至2022年11月北京大学肿瘤医院收治的92例结直肠癌卵巢转移患者的临床病例资料。比较分析所有患者术前癌胚抗原(CEA)、CA19-9、CA125及CA125/CEA。对76例行双侧卵巢切除术的患者和16例行双侧卵巢切除术的患者进行了配对研究, 以比较手术结果, 组间比较采用单因素方差分析。结果本研究共纳入92例患者作为研究对象, 平均年龄51.0(19.0～79.0)岁, 其中同步转移33(35.9%)例, 异时转移59(64.1%)例, 异时转移时间11.0(0.5～81.0)个月, 76(82.6%)例行双侧卵巢切除, 术后病理提示:双侧转移患者48(63.2%)例, 只有一侧转移共28例(36.6%), 16例(17.4%)行单侧卵巢切除, 9例(56.2%)发生术后对侧卵巢转移。71例(77.2%)患者术前血清CEA值异常, 80例(87.0%)患者术前CA125和CEA的比值<25, CEA与CA125和CEA...     

术前血清CA19-9联合CA125对肝内胆管癌术后病人预后预测价值研究

目的 评估术前血清CA19-9联合CA125水平对肝内胆管癌（ICC）根治术后病人预后的预测价值。
方法 回顾性分析2013年2月至2019年8月在中山大学附属第一医院行根治性手术切除,且术后病理学检查确诊为ICC的145例病人的临床病理及随访资料。采用Kaplan-Meier法,单因素和多因素COX比例风险模型分析预后相关的独立危险因素。比较不同CA19-9、CA125水平ICC病人的临床特征。 结果 单因素及多因素分析提示术前血清CA19-9及CA125水平都是ICC预后的独立危险因素（P=0.032,P=0.029）。根据术前CA19-9和CA125是否为阳性［CA19-9>37 kU/L为CA19-9（＋）,CA19-9≤37 kU/L为CA19-9（-）,CA125>35 kU/L为CA125（＋）,CA125≤35 kU/L为CA125（-）］分组结果显示：CA19-9（+）/CA125（+）组病人预后明显低于CA19-9（-）/CA125（-）或CA19-9（+）/CA125（-）组（P<0.001,P=0.008）。不论 CA19-9（+）或CA19-9（-）,CA125（+）病人肿瘤TNM分期较差（P=0.023,P=0.005）。结论 术前血清CA19-9联合CA125水平可更好的预测ICC病人的预后,原因可能与术前血清CA125阳性ICC病人TNM分期处于更晚期有关。     

肿瘤标记物CA125,CA199,CEA在卵巢癌诊断中的应用

目的:探讨血清CA125,CA199,和CEA单独检测和联合检测在卵巢癌诊断及疗效监洲中的作用.方法:用电化学发光法定量测定52例卵巢癌患者和30例正常人血清三种肿瘤标记物的变化并对检测效果进行评价.结果:卵巢癌患者血清CA-125,CA-199,CEA较正常组明显增高,CEA与CA-199的灵敏度无显著差别,而CA-125的特异性明显升高.联合检测CA-125,CA-199,CEA显示更大的优越性,在其敏感性达92.3%的基础上特异性达100%.卵巢癌患者治疗后血清中CA-125,CA-199,CEA的平均含量及阳性检出率与治疗前相比降低明显.结论;三种肿瘤标记物对卵巢癌均有一定的诊断价值,以CA-125,CA-199为优,联合检测对卵巢癌鉴别诊断有一定优势,同时认为检测血清中CA-125,CA-199,CEA水平对卵巢癌疗效监测是一种有效的检测手段.     

IS PARATHYROID HORMONE-RELATED PROTEIN A SENSITIVE SERUM MARKER IN ADVANCED BREAST CANCER?

Background : To compare already used serum markers in advanced breast cancer, namely erythrocyte sedimentation rate (ESR), carcino-embryonic antigen (CEA), and polymorphic epithelial mucins (e.g. CA15-3) with a newer potential marker: parathyroid hormone related protein (PTHrP). Methods : A study group of 33 patients of proven advanced breast cancer was compared with 11 patients with benign breast lumps who were undergoing surgery, and eight patients with humoral hypercalcaemia of malignancy of non-breast origin. ESR, CA15-3, CEA, PTHrP, parathormone (PTH), liver and renal function were measured using commercially available kits. Using given reference ranges, results were classified into normal versus abnormal, and univariate statistical comparisons were made using Fisher's exact test. For multivariate analysis, absolute serum levels were used, and multivariate logistic regression models were employed. Results : By univariate analysis, only CA15-3 (P= 0.007), and CEA (P= 0.004), were significant markers of metastatic disease. By multivariate analysis the only independently significant serum marker was CA15-3 (P= 0.043). PTHrP was neither a sensitive (22%) nor specific (90.1%) serum marker when compared to CEA or CA15-3. ESR was the most sensitive single serum marker (93%). An incidental finding of elevations of serum parathormone was found in as many patients as in the study group as there were elevations of PTHrP. Conclusions : PTHrP would not have revealed any patients with metastatic disease that would not have been predicted by any existing tumour markers including CA15-3, CEA and ESR. The finding of elevated PTH in as many patients as PTHrP indicates the possible need for a study inclusive of other polypeptide hormones as markers in advanced breast cancer.     

Tumor markers in patients undergoing hemodialysis or kidney transplantation.

The following tumor markers, AFP, CEA, CA 19-9, CA-125 and CA 15-3 were studied in 50 healthy volunteers (group A), in 23 patients on chronic hemodialysis (group B) and in 30 successfully transplanted individuals (group C) who did not present any clinical symptoms or signs of neoplasia. The levels of AFP, CEA and CA 15-3 were significantly higher in group B when compared to groups A and C. The levels of CA 19-9 and CA-125 did not differ significantly among the three groups. Transplanted individuals (group C) presented significantly lower levels of CEA and AFP and higher levels of CA 15-3 when compared to group B patients. The levels of all markers were not influenced by sex or time on dialysis. It is concluded that: (1) CA 19-9 and CA-125 can be considered as reliable tumor markers in patients undergoing hemodialysis or kidney transplantation. (2) The elevation of CEA and AFP levels in hemodialysis and their decline to normal levels found in the group of successfully transplanted individuals, suggest a possible active role of functioning renal tissue in their clearance. (3) The etiology of CA 15.3 elevation following successful kidney transplantation remains obscure and requires further evaluation.     

Preoperative CA 15-3 levels predict the prognosis of nonmetastatic luminal A breast cancer

Background

The prognostic value of serum tumor markers (STMs) in nonmetastatic breast cancer patients with different molecular subtypes (luminal A, luminal B, and nonluminal) remains unknown. It is our institutional policy to assess the STMs in nonmetastatic patients. This retrospective single-center study is to investigate the association between STMs and clinical outcomes in nonmetastatic patients and the impact of molecular subtypes.

Methods

A total of 368 patients with available clinical outcomes, tumor node metastasis stages, and STMs levels were included. The serum level of preoperative STMs (carcinoembryonic antigen [CEA], cancer antigen 125 [CA-125], and cancer antigen 15-3 [CA 15-3]) was analyzed and compared among distinct molecular subtypes. Univariate and multivariate analyses were used to investigate the relationship among STMs concentrations and patient outcomes.

Results

The median levels of CA 15-3 were 10.2, 8.1 and 7.1 U/mL in patients with luminal A, luminal B, and nonluminal diseases, respectively (P = 0.015). The levels of CEA and CA-125 were similar among the subtypes. Multivariate analysis showed that higher CA 15-3 was significantly associated with worse clinical outcomes exclusively in luminal A patients (P = 0.033 for metastasis-free survival and P = 0.030 for relapse-free survival). In contrast, higher CEA was a significant prognostic factor for worse clinical outcomes (P = 0.003 for metastasis-free survival and P = 0.015 for metastasis-free survival) in nonluminal groups.

Conclusions

The prognostic value of preoperative STMs may be different among molecular subtypes. Patients with luminal A diseases had higher levels of CA 15-3. Higher preoperative CA 15-3 was associated with worse clinical outcomes exclusively in patients with luminal A diseases.     

乳腺癌患者血清肿瘤标志物及细胞因子的临床意义

目的探讨血清肿瘤标志物CEA、CA15-3、CA19-9、β-hCG及细胞因子TNF-α、IL-6检测在乳腺癌诊断中的价值。方法选取不同临床分期乳腺癌患者145例、乳腺癌良性肿瘤60例、正常对照50例,通过蛋白芯片法和酶联免疫吸附法测定各项指标浓度并进行比较。结果乳腺癌CEA、CA15-3、CA19-9、β-hCG及细胞因子TNF-α、IL-6的血清浓度均显著高于良性肿瘤组和正常对照组（P〈0.01）,且与肿瘤分期密切相关。结论 CEA、CA15-3、CA19-9、β-hCG及细胞因子TNF-α、IL-6均为乳腺癌重要的肿瘤标志物,其含量可能与乳腺癌的发生、发展有关,测定其含量可作为临床病情观察和监测疗效的辅助手段。     

Serum levels of CEA and CA15-3 in different molecular subtypes and prognostic value in Chinese breast cancer

The prognostic significance of preoperative carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels in breast cancer is controversial. This study evaluated the prognostic value of preoperative serum CEA and CA15-3 levels in Chinese breast cancer patients. A total of 470 patients with breast cancer had preoperative CEA and CA15-3 concentrations measured. The relationships between preoperative concentration and clinicopathological factors and outcomes were determined. CEA and CA15-3 levels were increased in 34 (7.2%) and 58 (12.3%) patients, respectively. Elevations of serum CEA and CA-15-3 levels correlated with the primary tumor size and axillary lymph node status. CEA levels were lower in patients with triple-negative breast cancer than in those with other subtypes (P = 0.002). The 5-year distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) of CEA-negative vs. CEA-positive patients were 84.1% vs. 54.5% (P < 0.001), 82.7% vs. 54.8% (P < 0.001), and 89.7% vs. 78.5% (P = 0.007), respectively. The 5-year DMFS, DFS, and OS of CA15-3-negative vs. CA15-3-positive patients were 84.0% vs. 69.6% (P = 0.002), 83.0% vs. 66.2% (P < 0.001), 90.9% vs. 74.2% (P = 0.005), respectively. Multivariate analysis of prognosis indicated that CEA and CA15-3 levels were independent prognostic factors for DMFS (P = 0.021) and DFS (P = 0.032), and DFS (P = 0.014) and OS (P = 0.032), respectively. Serum levels of CEA and CA15-3 may differ in breast cancer molecular subtypes and preoperative levels of CEA and CA15-3 have a significant effect on prognosis in Chinese women with breast cancer.     

The correlation between the immunohistochemical expression of DF3 antigen and serum CA15-3 in breast cancer patients

The immunohistochemical expression of DF3 antigen and serum concentrations of CA15-3, a breast carcinoma-associated antigen recognized by the monoclonal antibodies (MAbs) 115D8 and DF3, was investigated in breast cancer patients. The levels of serum CA15-3 in 23 primary breast cancer patients did not correlate to the percentage cytoplasmic reactivity of MAb DF3 with the carcinoma cells in tissue specimens from each respective patients. In 17 patients who subsequently developed metastatic breast cancer, however, the serum CA15-3 concentrations generally correlated well to the cytoplasmic reactivity of MAb DF3 with the carcinoma cells in specimens obtained at initial biopsy or mastectomy. Elevated levels of serum CA15-3 were seen in metastatic breast cancer patients when the carcinoma cells in their primary specimens expressed enhanced levels of cytoplasmic DF3 antigen. The results of this study suggest that the immunohistochemical demonstration of DF3 antigen in tissue specimens, together with the periodical measurement of circulating CA15-3 antigen, may be important for monitoring the clinical course of breast cancer patients.     

Metastatic prostate cancer with normal level of serum prostate-specific antigen

The clinical and pathological features of metastatic prostate cancer with normal level of serum prostate-specific antigen (PSA) were investigated. Four patients with metastatic prostate cancer had serum PSA within the normal range at the diagnosis. All tumors were poorly-differentiated adenocarcinoma. Endocrine therapy was performed as the initial therapy in all patients. Despite subsequently treatment, all cases died of prostate cancer at 2, 8, 9 and 38 months. During disease progression, 3 of 4 patients had elevated serum markers such as carcinoembryonic antigen (CEA), CA19-9, CA15-3, CA125, neuron-specific enolase and pro-gastrin releasing peptide. Immunohistochemical examination of the initial biopsy specimens revealed that 4 and 3 cases were positive for CEA and chromogranin A, respectively. In advanced prostate cancer patients with low PSA level, those markers may aid in the follow up of disease.     

Prediction of extravesical disease by preoperative serum markers in patients with clinically organ confined invasive bladder cancer

PURPOSE: We assessed the value of preoperative levels of CEA, CA-125 or CA 19-9 in patients with clinically organ confined bladder cancer to predict pathological extravesical and/or node positive disease. MATERIALS AND METHODS: Serum levels of CEA, CA-125 and CA 19-9 were measured prospectively in all patients scheduled for cystectomy for clinically organ confined bladder cancer between September 1999 and May 2004. Biomarker expression was compared between patients with pathologically organ confined disease (pT2 or less, pN0) and patients with extravesical disease (greater than pT2, or pN1 or greater), and between patients with pathologically node negative (any pT, pN0) and node positive disease (any pT, pN1 or greater). RESULTS: Of the 91 patients enrolled, 46 had (51%) pathologically organ confined tumors, 45 (49%) had extravesical disease and 17 (19%) had positive lymph nodes. Preoperative serum levels of all markers were significantly higher in cases of extravesical disease than in organ confined disease. On multivariate analysis CEA with an odds ratio of 8.6 (95% CI 1.51-48.6) and CA-125 with an OR of 29.5 (95% CI 3.6-242.6) proved independent predictors of extravesical disease. CA-125 and CA 19-9 levels were significantly higher in patients with node positive disease than in those with node negative disease. On multivariate analysis CA-125 with an OR of 22.2 (95% CI 3.8-129) and CA 19-9 with an OR of 5.2 (95% CI 1.09-24.76) proved independent predictors of node positive disease. CONCLUSIONS: Increase in serum tumor markers before cystectomy in patients with clinically organ confined muscle invasive bladder cancer is a strong indicator of the presence of extravesical and node positive disease.     

CA19-9对胰腺癌手术可切除性的预测价值

目的探讨肿瘤标志物CA19-9等对胰腺癌手术可切除性的术前预测价值。方法回顾性分析病理证实的胰腺癌手术病人221例,据手术方式分为根治性胰十二指肠切除术组（PD）和姑息性手术组;将有术前血清CA19-9检测结果的病人分为CA19—9正常、轻度升高和异常升高组,根据术中情况进行TNM分期。结果CA19—9升高率在PD组为64．41％,在姑息组为79．45％。所有胰腺癌病人CA19—9异常升高率为82．86％;PD组CA19—9水平显著性低于胰腺癌不能切除组（P=0．035）。结论不能行根治性切除的胰腺癌病人血清CA19-9水平显著的高于能行根治性手术的病人,血清CA19-9〉1000u／ml可做为判定胰腺癌难以行根治性手术切除的参考指标。联合检测肿瘤标志物无助于早期诊断和预测胰腺癌的可切除性。