肿瘤标志物CEA、CA15-3和CA125在乳腺癌化疗疗效评估中的价值

目的：探讨CEA、CA15-3以及CA125在监测乳腺癌化疗疗效评估中的价值。方法：选择2005年6月～2008年1月在我科行化疗的晚期乳腺癌患者共45例，采用化学发光法测定血清CEA、CA15-3和CA125水平。化疗方案采用标准FAC、AC-D、DA、XD、GC等方案。化疗临床疗效评价采用WHO标准，肿瘤标志物疗效评价标准参考Bac[1]等的方法。结果：治疗后CEA、CA15-3在完全缓解组（CR）和部分缓解组（PR）组出现明显减低、进展组（PD）组明显升高（P〈0.05），而在稳定组（SD）组则无显著变化（P〉0.05）；CA125在CR和PR组出现显著降低（P〈0.05），在SD、PD组治疗前后无显著变化（P〉0.05）。CEA、CA15-3、CA125以及三者联合进行的肿瘤标志物评价与临床疗效评价的总符合率分别为60.0%（27/45）、55.6%（25/45）、31.1%（14/45）和73%（33/45）。结论：CEA、CA15-3和CA125可较好地监测乳腺癌化疗疗效，三者联检将提高监测效果。

Clinical Applicability of Determination of Serum Tumor Markers(CEA,CA15-3 and CA125) Levels Changes for Assessment of Efficacy of Chemotherapy in Patients with Breast Cancer

Objective To study the usefulness of monitoring changes of serum levels of tumor markers （ CEA, CA15 -3 and CA125） for assessment of efficacy of chemotherapy in patients with breast cancer. Methods Serum CEA, CA15 -3 and CA125 levels were measured with CLIA three days before beginning 1st course of appropriate chemotherapy and 3 weeks after completing 2nd course of treatment in 45 patients with advanced breast cancer （ TNM stage Ⅲ, n = 20, stage Ⅳ n = 25）. Results Expressed as CR, PR, SD and PD as defined by the changes of serum tumor markers levels （ according to Bac D.J. et al） were compared with clinically observed ones （ WHO standard）. The serum levels of CEA, CA15 - 3 decreased markedly in the CR and PR groups of patients but increased markedly in PD patients （ P 〈 0.05 ） with no significant changes in SD patients. CA125 levels also dropped significantly in CR and PR patients serum （ P 〈 0.05 ） but changes not significantly in SD and PD patients （ P 〉 0.05 ）. The coincidence rate between the results observed clinically and results derived from tumor marker changes was 50.0% for CEA, 55.6% for CA15 -3, 31.1% for CA125 and 73% for three markers combined. Conclusion Combined determination of the changes of serum levels of three tumor marker would help to make a reasonably satisfactory assessment of efficacy of chemotherapy in patients with breast cancer.