Serum tumour markers CA 15-3, TPA,TPS, hCG β and TATI in the monitoring of chemotherapy response in metastatic breast cancer

The clinical utility of CA 15-3, polypeptide specific antigen (TPS), tissue polypeptide antigen (TPA), human chorionic gonadotropin (hCGbeta) and tumourassociated trypsin inhibitor (TATI ) as indicators of chemotherapy response was assessed in advanced breast cancer. Serum was prospectively collected in one center before treatment (after the first course of chemotherapy) and at response evaluation from 57 patients taking part in a multicentre randomized trial comparing docetaxel with sequential methotrexate and 5-fluorouracil in the treatment of advanced breast cancer. The pretreatment levels of the serum markers were not predictors of the later response to treatment. Changes in the TPS level showed the strongest association with clinical response after the first course of chemotherapy and CA 15-3 at the best response evaluation. However, distinct mismatches occurred with every marker. The most problematic error was an increase in marker levels in patients with clinical responses, which might have caused interruption of therapy. This occurred in 8% and 17% of patients after the first course of chemotherapy and in 4% and 17% of patients at the best response evaluation with CA 15-3 and TPS, respectively. Moreover, after the first course of chemotherapy only 39% and 33% of the patients with progressive disease could be identified on the basis of increasing levels of CA 15-3 and TPS, respectively. Later, at clinical disease progression, TPA and TPS were found to be better indicators of disease progression than CA 15-3. In conclusion, changes in CA 15-3 or TPS levels usually correlate with clinical response, but owing to distinct discordances, they should not be used as sole indicators of response to chemotherapy in advanced breast cancer.     

血清TK1、TPS、CA15-3联合检测在乳腺癌诊断中的临床价值

目的 探讨血清胸苷激酶1(TK1)、特异性组织多肽抗原(TPS)、糖类抗原15-3(CA15-3)联合检测在乳腺癌诊断中的临床价值.方法 采用免疫印迹-增强化学发光法对乳腺癌组(69例)、乳腺良性疾病组(52例)、健康对照组(48例)血清TK1进行检测,采用酶联免疫吸附试验(ELISA)对血清TPS进行检测,采用化学发光法对血清CA15-3进行检测,并对检验结果进行统计学分析.结果 乳腺癌患者血清TK1、TPS、CA15-3水平均显著高于乳腺良性疾病组与健康对照组(P＜0.01),3项指标联合检测的敏感性显著高于单项检测或2项联合检测(P＜0.05).结论检测血清TK1、TPS、CA15-3水平,对乳腺癌的诊断具有重要的价值,3种标志物联合检测能明显提高乳腺癌诊断的敏感性.     

血清CEA和CA15-3水平对乳腺癌化疗疗效及预后评估的价值分析

目的探讨血清CEA和CA15-3水平对乳腺癌化疗疗效及预后评估的价值。方法回顾性分析2011年5月至2012年6月荆州市第一人民医院肿瘤科收治的63例乳腺癌晚期患者作为乳腺癌组,根据存活情况将其分为存活组(n=42例)和死亡组(n=21例),采用荧光免疫法检测血清CEA和CA15-3水平,随访4年,统计分析所有患者生存预后情况。结果Ⅳ期乳腺癌患者血清CEA和CA15-3水平明显高于Ⅲ期,差异有统计学意义(P0.05);CEA、CA15-3、CEA和CA15-3表达阴性组化疗有效率明显高于阳性组,差异有统计学意义(P0.05);所有患者随访1~4年,平均随访时间3.63年,最终有42例存活4年以上,CEA阳性组患者4年生存率(55.26%)明显低于阴性组(84.00%),差异有统计学意义(P0.05),CA15-3阳性组患者4年生存率(52.78%)明显低于阴性组(85.19%),差异有统计学意义(P0.05),CEA和CA15-3阳性组患者4年生存率(52.38%)明显低于阴性组(95.24%),差异有统计学意义(P0.05);存活组化疗前血清CEA和CA15-3水平明显低于死亡组,差异有统计学意义(P0.05)。结论检测乳腺癌患者化疗前血清CEA和CA15-3水平可为化疗疗效及预后评估提供可参考数据。     

三项肿瘤标志物联合检测在乳腺癌诊断中的价值

目的研究3项肿瘤标志物的联合检测在乳腺癌诊断中的临床应用。方法用ELISA方法检测98例乳腺癌患者,73例乳腺良性疾病患者和50例体检健康者血清中的组织多肽特异性抗原（TPS）;同时用微粒子酶免分析法检测血清中糖类抗原15-3（CA15-3）,糖类抗原125（CA125）水平;并用约登指数和受试者工作特征曲线（ROC曲线）分析3项肿瘤标志及其联合检测乳腺癌的效能。结果乳腺癌患者血清TPS,CA125和CA15-3的水平和阳性率均显著高于良性对照组和正常对照组（P〈0.05）。3项肿瘤标志物中,TPS敏感度最高（36.7%）,ROC曲线下面积最大（0.717）,特异性稍低（83.74%）。联合检测中,TPS＋CA153或TPS＋CA125组合约登指数最高（20.69%）,敏感性为37.76%,特异性为82.93%。结论 3项肿瘤标志物中,TPS敏感性较高,可用于乳腺癌病人的检出,TPS和CA153或CA125的联检对于乳腺癌的诊断具有一定的临床价值。     

联合检测TPS和CA125在卵巢癌患者诊疗中的意义

【目的】探讨血清TPS和CA125与卵巢癌的关系,为卵巢癌的临床诊断、病情监测提供新方法。【方法】用ELISA法分别检测卵巢良性肿瘤和卵巢癌患者化疗前后血清TPS和CA125水平。【结果】卵巢癌患者血清TPS和CA125水平均较良性肿瘤患者高,差异有显著性(P<0. 01)。血清TPS和CA125诊断卵巢癌的敏感度和特异度无差别。卵巢癌患者2个疗程化疗后血清TPS和CA125水平显著下降(P<0. 01 )。【结论】血清TPS和CA125均可作为卵巢癌诊断、病情监测的临床指标,二者联合检测可提高其临床应用价值。     

血清组织多肽特异性抗原表达水平在乳腺癌中的临床应用价值探讨

目的分析血清组织多肽特异性抗原(TPS)水平与乳腺癌生物学行为的相关性,探讨血清TPS表达在乳腺癌中的临床应用价值。方法回顾性选取2019年1月至2020年1月在首都医科大学附属北京天坛医院住院治疗的乳腺癌患者85例为乳腺癌组;选取同时期诊断为乳腺良性肿瘤的患者83例为良性疾病组;选取同时期健康体检者86例为健康对照组。应用酶联免疫吸附实验(ELISA)法检测所有入选对象的血清TPS表达水平,分析比较血清TPS的表达情况与是否发生淋巴结转移、TNM分期、病理学分化程度、雌、孕激素受体及Cer Bb-2基因等的关系,同时检测TPS与肿瘤标志物CEA、CA15-3、CA125联合检测在乳腺癌诊断中的灵敏度及特异度情况。结果乳腺癌组患者TPS表达水平及阳性率显著高于良性疾病组和健康对照组(P <0.05),乳腺癌患者经治疗后血清TPS表达水平明显降低,与治疗前比较差异有统计学意义(P <0.05);乳腺癌患者血清TPS表达与年龄、肿瘤直径无关(P> 0.05),与临床TNM分期、腋窝淋巴结转移、肿瘤分化程度密切相关(P <0.05)。TPS联合CEA、CA15-3和CA125检测可大幅度提高乳腺癌诊断的灵敏度和特异度,与单独使用TPS指标相比差异具有统计学意义(P <0.05)。结论血清TPS的表达水平与乳腺癌患者生物学行为存在相关性,其可作为乳腺癌早期诊断、治疗效果评价、复发转移及预后判断的临床指标,为乳腺癌患者的临床治疗及预后判断提供有力的依据和新思路。     

血清肿瘤标志物检测在乳腺癌诊断中的意义

目的:探讨血清糖类抗原153(carbohydrate antigen 153,CA153)、铁蛋白(serum ferritin,SF)、组织多肽特异性抗原(tis-sue polypeptide specific antigen,TPS)对乳腺癌诊断的意义。方法:用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)分别检测38例乳腺癌患者、28例乳腺良性肿瘤患者和20例正常健康女性血清CA153、SF、TPS水平。结果:血清CA153、SF、TPS水平在乳腺癌组中显著高于乳腺良性肿瘤组和正常对照组(P<0.01);SF、TPS水平随着乳腺癌临床分期的增加而增高;CA153、SF、TPS对乳腺癌诊断的敏感性分别为52.6%、60.5%、65.8%,三者联合检测对乳腺癌诊断的敏感性为86.8%。结论:CA153、SF、TPS对乳腺癌诊断有一定价值,TPS与CA153、SF联合检测有互补性,可提高对乳腺癌诊断的敏感性。     

血清ProGRP、TPS及NSE在小细胞肺癌患者治疗监测中的应用

目的 分析评价血清ProGRP、TPS和NSE在SCLC患者临床诊断和疗效监测中的临床意义.方法 分别采用化学发光法、ELISA法和电化学发光法测定51例SCLC患者(SCLC组,局限期患者36例,广泛期患者15例)、60例肺良性疾病患者(良性疾病对照组)及60名健康人(健康对照组)血清ProGRP、TPS和NSE浓度;分析评价3项指标在SCLC患者治疗前、化疗第1周期和第2周期的变化.结果 局限期SCLC患者治疗前的血清ProGRP、TPS和NSE浓度分别为136.9(22.8～631.7)ng/L、78.2(56.4～114.6)U/L和28.1(20.9～46.1)μg/L;广泛期为1 106.6(41.2～2 161.1)ng/L、230.9(143.5～259.0)U/L和81.1(34.3～140.0)μgL;肺良性疾病组为19.7(9.5～29.1)ng/L、48.7(17.9～95.4)U/L和12.1(1.2～13.9)μg/L;健康对照组为20.3(10.7～30.6)ng/L、50.3(19.5～70.7)U/L和11.7(1.1～13.4)μg/L;经Kruskal-Wallis检验,3项指标在各组间的差异均有统计学意义(x2值分别为51.368、36.532和81.645,P均＜0.01);两个对照组分别与局限期SCLC比较,差异均有统计学意义(U值分别为491、827、609和476、831、585,P均＜0.05);两个对照组分别与广泛期SCLC比较,差异亦有统计学意义(U值分别为314、532、456和302、553、430,P均＜0.01).血清ProGRP诊断SCLC的ROC曲线AUC为0.832±0.029(95%CI:0.774～0.890),以37.7 ng/L为临界值时,其敏感度、特异度、阳性预测值、阴性预测值和约登指数分别为71%(36/51)、97%(116/120)、90%(36/40)、89%(116/131)和67%.联合检测时,ProGRP+TPS+NSE、ProGRP+TPS、ProGRP+NSE和TPS+NSE组合的敏感度分别为92%、86%、92%和88%,特异度分别为77%、77%、92%和77%.经非参数Fridman检验,3项指标在不同治疗阶段的差异均有统计学意义(x2值分别为49.120、10.614和44.392,P均＜0.01).经过连续2个周期化疗后,血清ProGRP浓度持续降低,分别降低至68.0(18.6～158.4)和21.0(14.9～63.5)ng/L,与化疗前组比较,差异均有统计学意义(Z值分别为-4.889、-5.594,P均＜0.01);血清TPS在第1周期化疗结束后升高至105.2(54.1～181.2)U/L,但差异无统计学意义(Z=-1.248,P＞0.05),在第2周期化疗结束后明显降低至79.0(48.7～155.3)U/L,差异有统计学意义(Z=-2.484,P＜0.05);血清NSE在第1周期化疗后迅速降低至11.8(8.0～16.0)μg/L,差异有统计学意义(Z=-5.568,P＜0.01),第2周期化疗后降为10.6(9.0～12.7)μg/L,与第1化疗周期结束后相比,差异无统计学意义(Z=-1.851,P＞0.05).在2个周期化疗后,临床治疗有效的SCLC患者46例(CR 3例,PR 43例),其中3项指标的检测结果全部正常或仅有1项超过临界值的患者为38例(各19例),占83%;3项指标全部异常的患者2例,临床疗效评价均为PD;还有2例临床疗效评价为SD和1例未评价的患者均有2项指标结果异常.结论 血清ProGRP、TPS和NSE均为诊断和监测SCLC治疗疗效的较好的指标,尤其以ProGRP+NSE组合的临床诊断价值最高.联合应用3项指标,有助于SCLC患者的疗效监测和预后判断.

Abstract：

Objective To evaluate the clinical significance of serum levels of ProGRP, TPS and NSE in diagnosis and therapy monitoring in small cell lung cancer patients. Methods The levels of serum ProGRP, TPS and NSE in 51 SCLC patients (SCLC group), 60 benign pulmonary disease patients (benign disease group ) and 60 healthy people (healthy group ) were determined using chemiluminescent immunoassay, ELISA and electrochemiluminescent immunoassay respectively. Blood samples were collected and detected prior to therapy, before the second course of chemotherapy and the third course of chemotherapy consecutively in all the 51 SCLC patients. Results The serum ProGRP, TPS and NSE concentrations prior to chemotherapy in limited stage SCLC (LSCLC) were 136. 9(22.8-631.7)ng/L, 78. 2(56.4-114.6) U/L and 28.1(20.9-46.1)μg/L, respectively; And in extensive stage SCLC patients (ESCLC) were 1 106.6(41.2-2161.1) ng/L, 230. 9( 143.5-259.0) U/L and 81.1 (34.3-140.0)μg/L, respectively. The serum concentrations of the 3 markers in benign disease group were 19. 7 ( 9. 5-29. 1 )ng/L, 48. 7 ( 17.9-95.4) U/L and 12. 1(1.2-13.9) μg/L; and in healthy group were 20.3(10.7-30.6) ng/L, 50.3(19.5-70.7) U/L and 11.7 (1.1-13.4)μg/L, respectively. The Kruskal-Wallis test showed significantly statistical difference in different groups of the 3 tumor markers, Chi-Square were 51. 368,36. 532 and 81. 645( P ＜0. 01 ). Significant statistically differences showed when the concentrations of the 3 marks of the 2 control group were compared with that of the LSCLC group ( U =491, 827, 609 and 476, 831, 585,respectively, P ＜ 0. 05 ). Differences were also statistically significant when the 2 control group compared with that of the ESCLC group ( U = 314,532,456 and 302,553,430, respectively, P ＜ 0. 01 ). The AUC of ProGRP was 0.832 +0.029(95% CI:0.774-0.890). When cutoff value of ProGRP set as 37.7 ng/L, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and Youden's index were 71% (36/51), 97% (116/120), 90% (36/40), 89% ( 116/131 ) and 67%, respectively; show good detection performance. The sensitivity increased to 92%, 86%, 92% and 88%, when combination detection of ProGRP + TPS + NSE, ProGRP + TPS, ProGRP + NSE and TPS + NSE were used, and the specificities were 77%, 77% , 92% and 77% accordingly. The Fridman test showed significantly statistical difference in the 3 tumor markers at different stages of treatment, x2 were 49. 120, 10. 614 and 44. 392, P ＜0. 01. After the first chemotherapy course, all the tumor marker levels except TPS decreased significantly in comparison with the pretreatment concentrations. However, only ProGRP levels showed a progressive drop during the two consecutive courses of therapy, and the median concentrations were 68.0 ( 18. 6-158.4 ) and 21.0( 14. 9-63.5) ng/L (compared to the level before therapy,Z=-4. 889 and -5. 594, P ＜0. 01 ). The median of serum TPS increased slightly to 105.2 (54. 1-181.2 ) U/L after the first chemotherapy course (Z=-1.248, P＞0.05), and decreased significantly to 79.0(48.7-155.3) U/L after the second chemotherapy course (Z=-2.484, P＜0. 05 ). As to the NSE, the median concentration decreased to 11.8(8.0-16.0)μg/L after the first chemotherapy course ( Z= - 5. 568, P ＜ 0. 01 ). However, the median was 10. 6(9.0-12.7)μg/L, which showed no significant decrease after the second chemotherapy course (Z=-1.851, P＞0.05).Forty-six SCLC patients evaluated as clinical remission ( 3 CR and 43 PR) after the second chemotherapy course, among them there were 38 patients (83%) with normal serum ProGRP, TPS and NSE level ( 19 patients) or with only 1 abnormal tumor level ( 19 patients). There were only 2 patients with all abnormal serum ProGRP, TPS and NSE level, and both patients were evaluated as clinical PD. Two patients with 2 abnormal tumors results were classified as SD, the only 1 patient without therapy evaluation also had 2 abnormal tumor marker results. Conclusions The serum ProGRP, TPS and NSE are valuable tumor markers for diagnosis and treat monitoring of SCLC, particularly the ProGRP + NSE shows the highest clinical value. Combing detection of the 3 tumor markers are valuable for therapy monitoring and prognosis in SCLC patients.     

血清CYFRA21-1，HCY 及CA15-3 水平联合检测对乳腺癌辅助诊断的临床评价

目的　探讨血清细胞角蛋白19 片段（cytokeratin 19 fragment,CYFR21-1）、同型半胱氨酸（homocysteine, HCY）和糖类抗原15-3(carbohydrate antigen 15-3,CA15-3) 在乳腺癌患者体内的表达水平及其在乳腺癌诊断中的 价值。方法　选取2019 年1~11 月期间收治的乳腺癌患者73 例为研究对象,良性乳腺瘤患者95 例为疾病对照组, 同期体检的健康志愿者80 例为正常对照组,分别检测并比较三组研究对象CYFRA21-1,HCY 和CA15-3 水平, 分析其对乳腺癌诊断的价值。结果　乳腺癌组的CYFRA21-1,HCY 和CA15-3 检测水平分别为6.25±1.60ng/ml, 19.42±3.67μmol/L 和40.84±6.77U/ml;良性乳腺瘤组的CYFRA21-1,HCY 和CA15-3 检测水平分别为1.28±0.38 ng/ml,11.72±2.46μmol/L 和16.44±3.71 U/ml;对照组的CYFRA21-1,HCY 和CA15-3 检测水平分别为0.86±0.21 ng/ml,9.57±2.22μmol/L 和12.84±2.69 U/ml,结果显示乳腺癌组的三项指标表达水平明显高于乳腺瘤组和对照 组,差异均有统计学意义（F=22.314~97.593,均P ＜ 0.05）。乳腺癌晚期患者（Ⅲ - Ⅳ期）血清CYFRA21-1, HCY 和CA15-3 水平显著高于早期患者（Ⅰ - Ⅱ期）,差异均有统计学意义（t=6.311~11.720, 均P ＜ 0.05）。血清 CYFRA21-1,HCY 和CA15-3 联合检测灵敏度和准确度分别为89.04% 和83.33%,与单项检测比较差异均有统计学 意义（t=2.655~21.196,均P ＜ 0.05）。结论　CYFRA21-1,HCY 和CA15-3 联合检测可明显提高乳腺癌诊断的灵 敏度和准确度,为临床提供经济快捷有效的实验室依据。     

血清肿瘤标志物CA15-3对Her-2阳性乳腺癌术后化疗疗效的评估价值

目的探讨糖类抗原CA15—3在Her-2过表达乳腺癌患者术后化疗疗效监测的评估价值。方法回顾性分析66例Her-2阳性乳腺癌患者术后以蒽环类及紫杉类（44例采用Herceptin生物化疗）为基础化疗过程中血清CA15-3的变化。根据2000年RECIST标准分有效组（OR组）及无效组（NR组）,通过分析两组治疗前后血清CA15-3变化及治疗前后CA15-3下降比率绘制ROC曲线特征评估其对化疗疗效的价值。结果与治疗前相比,所有患者治疗后CA15-3血清水平显著下降（P〈0．05）,治疗前有效组及无效组间CA15-3血清水平无明显差异（P〉0．05）,有效组治疗前后CA15-3血清水平与化疗相关,治疗前后有显著差异（P〈0．05）,而无效组治疗前后与化疗无相关,治疗前后无显著差异（P〉0．05）,治疗前后CA15—3下降比率绘制ROC曲线,其曲线下面积为O．527。采用Herceptin的生物化疗患者,与治疗前相比治疗后CA15—3血清水平亦显著下降（P〈0．05）,治疗前有效组及无效组间CA15-3血清水平亦无明显差异（P〉0．05）,有效组治疗前后CA15—3血清水平与化疗相关,治疗前后有显著性差异（P〈0．05）,而无效组治疗前后血清CA15-3水平与化疗相关（P〈0．05）,但无显著性差异（P〉0．05）。采用治疗前后CA15-3下降比率绘制ROC曲线,其曲线下面积为O．618。结论CAl5-3在Her-2阳性乳腺癌患者术后化疗疗效有一定预测作用,在Herceptin为基础的生物化疗中有一定的敏感性及特异性。     

CA 15-3 and carcinoembryonic antigen in the clinical evaluation of breast cancer

The individual and combined value of CA 15-3 and carcinoembryonic antigen (CEA) as breast cancer tumor markers was investigated in longitudinal studies. Patients included women at high risk for recurrence after primary therapy or undergoing treatment for metastatic disease. During follow-up, recurrent disease was documented in 33 of 39 (85%) patients including 11 with local recurrence and 22 with distant metastases. At the time recurrence was first documented by objective criteria 23 of 33 (70%) of the patients presented with abnormal CA 15-3 levels (>36.7 U/ml) compared with 19/33 (58%) with abnormal CEA levels (5 ng/ml). Tumor marker elevations predominated in patients with advanced disease indicating that CA 15-3 and CEA are not reliable for the detection of early breast cancer. Both markers were helpful in monitoring therapeutic response since antigen levels correlated closely with disease status.     

The pretreatment plasma level and diagnostic utility of M-CSF in benign breast tumor and breast cancer patients

BACKGROUND: In the present study, we investigated the plasma levels of M-CSF and commonly accepted tumor marker (antigen CA 15-3) in breast cancer patients in relation to the group with benign breast tumor and to the healthy controls. Additionally, we compared the plasma level of M-CSF with the tumor stage of breast cancer and defined the diagnostic criteria: sensitivity, specificity, the positive and the negative predictive values. Moreover, we defined the receiver-operating characteristics (ROC) curve for M-CSF and CA 15-3, and correlation between both parameters. METHODS: M-CSF and CA 15-3 were measured in 80 patients with breast cancer, 17 patients with benign breast tumor and in 30 healthy subjects. M-CSF was determined using enzyme-linked immunosorbent assay (ELISA). CA 15-3 was measured using a microparticle enzyme immunoassay kit (MEIA). RESULTS: There were statistically significant differences in the levels of circulating M-CSF and CA 15-3 in the breast cancer patients comparing to the group with benign breast tumor and to the control group. The levels of M-CSF and CA 15-3 were also significantly higher in patients with more advanced tumor stage. Statistically significant positive correlation was observed between the M-CSF and CA 15-3 levels. The M-CSF and CA 15-3 diagnostic specificities were 95%. The diagnostic sensitivity (59%), the positive predictive value (97%) and the negative predictive value (41%) were higher for M-CSF than for CA 15-3 (48.8%, 95% and 40.1%, respectively). The combined use of both cytokines resulted in the increase of the sensitivity to the range of 70%. We observed a higher range of the diagnostic sensitivity of M-CSF in more advanced breast tumor stage. The M-CSF area under the ROC curve was larger (0.801) than the ROC area of CA 15-3 (0.785). CONCLUSIONS: These results suggest that M-CSF is the good candidate for a breast cancer tumor marker.     

乳腺癌及前驱病变肿瘤分子标记物联合动态监测的研究与临床应用

目的：探讨乳腺癌及前驱病变肿瘤分子标记物联合动态监测的临床意义。方法：对100例乳腺癌、104例癌前病变（28例导管非典型增生ADH、31例低级别原位癌LG-DCIS、45例高级别原位癌HG-DCIS）患者采用化学发光法检测血清CA15-3、TPS、CA125的水平,化学显色法检测TSGF;ELISA法检测OPN分子标记物水平,并与30例正常乳腺组对照,结合ER、PR、c-erbB-2、Ki-67等临床病理因素统计分析。结果：与癌前病变组、正常乳腺对照组比较,乳腺浸润性导管癌分子标记物差异有统计学意义（P〈0．01）;与LG-DCIS、ADH及正常对照组比较,HG-DCIS血清CAl5-3、TSGF水平差异有统计学意义（P〈0．05）;LG-DCIS与ADH、正常对照组肿瘤标记物血清水平降低,但组间差异无统计学意义（P〉0．05）。血清肿瘤标记物水平与肿瘤大小（1cm为界）、患者年龄（50岁为界）、肿瘤部位、灶数（单灶、多灶）无关（P〉0．05）;与ER、PR、c-erbB-2、Ki-67差异相关,ER、PR阳性程度高,肿瘤标志物低负相关（P〈0．05）;c-erbB-2、Ki-67（20％为界）高则肿瘤标志物高正相关（P〈0．05）;淋巴结转移组与无转移组差异有统计学意义（P〈0．05）。与各单项检测相比,联合检测敏感性、准确性、阴性预测值明显提高,P〈0．05。结论：CA15-3、TPS、CA125、TSGF、OPN是乳腺导管癌诊断和监控转移的较好指标,对乳腺高级别粉刺型原位癌诊断和治疗、随访有-定价值,但对癌前病变诊断无特异性。     

CK19、CEA和CA19-9联合检测对结直肠癌术后化疗疗效及预后的评估价值

[目的]评价肿瘤标志物角蛋白19(CK19)、癌胚抗原(CEA)和癌链抗原19-9(CA19-9)联合检测对结直肠癌术后化疗效果及预后评估的临床价值.[方法]选取经手术后病理证实的68例结直肠癌患者,应用化学发光免疫分析方法检测第1周期化疗前后CK19的含量并结合化疗前、足疗程化疗后血清CEA、CA19-9的含量,联合...     

乳腺癌患者血清肿瘤标记物检测的临床应用

目的探讨血清癌抗原153（CA153）、组织多肽特异性抗原（TPS）和癌抗原125（CA125）联合检测对乳腺癌诊断的临床应用价值。方法采用电化学发光法检测患者血清中CA153、TPS、CA125。结果乳腺癌患者组血清三种标记物水平及阳性率均明显高于乳腺良性病变组和正常对照组（P〈0．01），联合检测的敏感性和诊断准确性均比单项检测高。结论联合检测血清中的CA153、TPS、CA-125对乳腺癌的早期诊断具有重要价值。     

卡培他滨联合多西他赛对晚期乳腺癌患者肿瘤标志物水平的影响

目的探究卡培他滨联合多西他赛对晚期乳腺癌患者肿瘤标志物水平的影响。方法随机选取于2010年12月至2015年12月该院收治的75例晚期乳腺癌患者作为研究对象,根据入院时间先后将患者分成观察组38例和对照组37例,对照组患者采用多西他赛治疗,观察组患者采用卡培他滨联合多西他赛治疗,观察并比较两组患者临床疗效、治疗前后血清癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原15-3(CA15-3)水平变化以及毒副反应发生情况。结果观察组患者接受治疗后,有效率(RR)为63.16%(24/38),疾病控制率(DCR)为86.84%(33/38);对照组RR为40.54%(15/37),DCR为67.57%(25/37),两组比较差异有统计学意义(P0.05)。两组患者治疗前血清中肿瘤标志物CEA、CA125及CA15-3水平比较差异无统计学意义(P0.05);治疗后,两组CEA、CA125及CA15-3水平较治疗前有明显降低,且差异有统计学意义(P0.05);治疗后观察组3种肿瘤标志物水平显著低于对照组,且差异有统计学意义(P0.05)。结论卡培他滨联合多西他赛治疗晚期乳腺癌患者后血清内肿瘤标志物水平显著降低,毒副作用轻,患者耐受性好,值得广泛推荐使用于临床当中。     

Serum tumor markers in breast cancer: are they of clinical value?

BACKGROUND: Although multiple serum-based tumor markers have been described for breast cancer, such as CA 15-3, BR 27.29 (CA27.29), carcinoembryonic antigen (CEA), tissue polypeptide antigen, tissue polypeptide specific antigen, and HER-2 (the extracellular domain), the most widely used are CA 15-3 and CEA. METHODS: The literature relevant to serum tumor markers in breast cancer was reviewed. Particular attention was given to systematic reviews, prospective randomized trials, and guidelines issued by expert panels. RESULTS: Because of a lack of sensitivity for early disease and lack of specificity, none of the available markers is of value for the detection of early breast cancer. High preoperative concentrations of CA 15-3 are, however, associated with adverse patient outcome. Although serial determinations of tumor markers after primary treatment for breast cancer can preclinically detect recurrent/metastatic disease with lead times of approximately 2-9 months, the clinical value of this lead time remains to be determined. Serum markers, however, are the only validated approach for monitoring treatment in patients with advanced disease that cannot be evaluated by use of conventional criteria. CONCLUSIONS: CA 15-3 is one of the first circulating prognostic factors for breast cancer. Preoperative concentrations thus might be combined with existing prognostic factors for predicting outcome in patients with newly diagnosed breast cancer. At present, the most important clinical application of CA 15-3 is in monitoring therapy in patients with advanced breast cancer that is not assessable by existing clinical or radiologic procedures.     

乳腺肿块患者血清CA15-3及CEA检测的临床意义

目的 探讨电化学发光法检测血清糖类抗原15-3(CA15-3)及癌胚抗原(CEA)在乳腺疾病诊断以及术后监测中的临床应用价值.方法 分析2005年5月至2006年12月间住院患者血清CA15-3及CEA检测结果,结合临床病历资料进行统计学分析.结果 乳腺良性肿块组与乳腺癌组CA15-3及CEA检测结果差异显著,血清CA15-3及CEA用于诊断乳腺癌的特异性较高(97.6%及96%),但敏感性较低(30.5%及13.9%);血清CA15-3异常的乳腺癌患者,术后CA15-3明显下降;CA15-3与CEA之间存在一定的相关性,但相关系数不高.结论 CA15-3及CEA在诊断早期乳腺癌时虽然特异性很高,但由于敏感性太低导致其临床应用价值有限,二者联合应用对提高诊断效率意义不大,当乳腺癌患者血清CA15-3较高时,可以用于评价治疗效果.对于乳腺癌的早期诊断,尚需寻找更敏感的标志物.     

肿瘤标志物在监测乳腺癌患者复发转移中的意义

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例良肚疾病者的血清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牛转移患者的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，埘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水平存乳腺癌患者巾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，而联合检测对监测孔腺癌进展期、复发和转移有重要的指导意义。