原发性乳腺癌患者术前血清中糖类抗原153癌胚抗原和组织多肽特异性抗原水平与临床病理特征和预后的关系

目的 探讨原发性乳腺癌患者术前血清中糖类抗原153( CA153)、癌胚抗原(CEA)和组织多肽特异性抗原(TPS)水平与患者临床病理特征和预后的关系.方法 对386例Ⅰ～Ⅳ期原发性乳腺癌患者的临床资料进行严格随访,回顾性分析患者术前血清中CA153、CEA和TPS水平与乳腺癌临床病理特征和预后的关系.结果 分别有383、382和324例患者进行了术前CA153、CEA和TPS的检测,平均表达水平分别为(21.46±34.88)U/ml、(1.53±7.95)μg/L和(224.87±436.19) AU/ml,CA153、CEA和TPS的阳性表达率分别为10.7％ (41/383)、7.6％ (29/382)和63.9％ (207/324).原发性乳腺癌患者术前血清CA153的表达水平与患者的年龄和肿瘤大小显著相关(均P＜0.05),CEA的表达水平与肿瘤大小显著相关(P＜0.05),TPS的表达水平与肿瘤大小和淋巴结转移状况显著相关(均P＜0.05).术前血清CA153、CEA和TPS阳性表达患者的总生存率显著低于阴性患者(均P＜0.05).Cox多因素分析表明,ER的表达水平以及术前CA153的表达水平是影响乳腺癌患者预后的独立因素(均P＜0.05),其中术前CA153水平增高是危险因素,而ER阳性表达则是保护因素.结论 术前血清CA153、CEA和TPS的表达水平与乳腺癌患者的临床病理特征和预后有关,CA153是影响乳腺癌患者预后的独立因素,CA153表达水平增高者的预后较差.

Clinical and prognostic significance of preoperative serum CA153, CEA and TPS levels in patients with primary breast cancer

Objective To investigate the clinical and prognostic values of preoperative serum CA153,CEA and TPS levels in patients with primary breast cancer.Methods A total of 386 hospitalized patients with stage Ⅰ ～ Ⅳ breast cancer from Nov 1998 to Feb 2009 were followed up,and their clinicopathological data were analyzed retrospectively to determine the factors affecting their prognosis.Results First,preoperative serum CA153 expression level was significantly associated with the age of onset and tumor size (P ＜ 0.05 ),the expression of serum CEA was correlated with tumor size ( P ＜ 0.05 ),and the expression of serum tissue polypeptide specific antigen (TPS) was correlated with tumor size and lymph node metastases ( P ＜ 0.05 ).Second,the overall survival was significantly shorter among patients with elevated serum CA153,CEA or TPS,respectively ( P ＜ 0.05 for overall).Finally,multivariate Cox regression analysis indicated that estrogen receptor status (ER) and elevated preoperative values of CA 153 are independent prognostic factors for overall survival (P ＜ 0.05 ),and CA 153 is a risk factor but estrogen receptor status is a protective factor for overall survival.Conclusions Higher preoperative expression of serum CA153,CEA or TPS is closely correlated with clinicopathological characteristics and overall survival.The prognosis is poorer in primary breast cancer patients with higher CA15-3 expression level,and pretreatment CA153 expression level can be used as an independent prognostic parameter in patients with primarily breast cancer.