切换至 "中华医学电子期刊资源库"
高级检索
中华乳腺病杂志(电子版)

中华乳腺病杂志(电子版) ›› 2012, Vol. 06 ›› Issue (03) : 253 -258. doi: 10.3877/cma. j. issn.1674-0807.2012.03.003

论著

血清肿瘤标记物β2微球蛋白、癌胚抗原、CA153和CA125检测对乳腺癌临床实践的意义探讨
华彬1, 阿合提别克·塔布斯2, 陆旭1, 肖文政1, 韩靖云3, 李波1,†()   
  1. 1.100730 北京,北京医院乳腺疾病中心
    2.830063 乌鲁木齐, 新疆医科大学第二附属医院普外科
    3.100730 北京,北京医院检验科
  • 收稿日期:2012-02-27 出版日期:2012-06-01
  • 通信作者: 李波

Significance of tumor markers including β2-microglobulin, carcino-embryonic antigen, CA153 and CA125 in clinical practice for breast cancer

Bin HUA1, Xu LU1, Wen-zheng XIAO1, Jing-yun HAN1, Bo LI1,†()   

  1. 1.Breast disease center, Beijing hospital, Beijing 100730, China
  • Received:2012-02-27 Published:2012-06-01
  • Corresponding author: Bo LI
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

华彬, 阿合提别克·塔布斯, 陆旭, 肖文政, 韩靖云, 李波. 血清肿瘤标记物β2微球蛋白、癌胚抗原、CA153和CA125检测对乳腺癌临床实践的意义探讨[J/OL]. 中华乳腺病杂志(电子版), 2012, 06(03): 253-258.

Bin HUA, Xu LU, Wen-zheng XIAO, Jing-yun HAN, Bo LI. Significance of tumor markers including β2-microglobulin, carcino-embryonic antigen, CA153 and CA125 in clinical practice for breast cancer[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2012, 06(03): 253-258.

目的

检测乳腺癌患者外周血中β2 微球蛋白(β2-MG)、癌胚抗原(CEA)、CA153、CA125 水平,以探讨外周血β2-MG、CEA、CA153、CA125 在乳腺癌临床实践中的作用。

方法

对140 例乳腺癌患者及144 例健康体检者应用免疫散射比浊法检测外周血β2-MG,用化学发光法检测外周血CEA、CA153、CA125 的水平,数据统计用Kruskal-Wallis 检验、Chi-square 检验和Wilcoxon 秩和检验。

结果

乳腺癌患者外周血β2-MG 和CEA 的检测值分别为1.8 (1.5 ~2.2) mg/L 和1.7(1.2 ~2.4) ng/ml,高于健康对照组[1.5(1.3 ~1.8)mg/L,1.2(0.9 ~1.9)ng/ml,P<0.05],且阳性率高于健康人群(P<0.05);以β2-MG 检测为基础,联合检测未增加诊断的敏感性(P>0.05);以临床分期为参照指标, CA153 在Ⅲ期患者的检测值明显高于Ⅰ期和Ⅱ期患者(P<0.05)。乳腺癌患者术后β2-MG、CEA、CA153 检测均有下降,与术前相比差异有统计学意义(P<0.05)。

结论

以β2-MG 为基础的联合诊断对乳腺癌诊断敏感性未见明显增加;血清CA153 检测水平对乳腺癌预后有一定的预测作用;β2-MG、CEA 和CA153 对乳腺癌术后随访有一定临床意义。

关键词: 乳腺肿瘤, 诊断, 预后, β2-微球蛋白, 癌胚抗原, CA153, CA125

Objective

To detect the levels of serum tumor marker β2-microglobulin(β2-MG), CEA, CA153 and CA125 so as to evaluate their clinical significance in clinical treatment of breast cancer.

Methods

The β2-MG level in peripheral blood was detected by nephelometry and the CEA, CA153 and CA125 levels in peripheral blood were determined by chemiluminescence method. Statistical analysis was performed using Kruskal-Wallis test,Chi-square test or Wilcoxon test.

Results

The β2-MG and CEA levels in peripheral blood were 1.8 (1.5-2.2) mg/L and 1.7(1.2-2.4) ng/ml in breast cancer patients respectively,which were higher than those of healthy controls[(1.5(1.3-1.8) mg/L,1.2(0.9-1.9) ng/ml,P<0.05]. The positive rate in breast cancer patients was higher than that in healthy control.On the basis of β2-MG test,combined tests of more than one tumor marker could not increase the sensitivity (P>0.05). According to clinical-pathologic stage, the CA153 level was statistically higher in stage Ⅲpatients than that in stage Ⅰor Ⅱ(P<0.05);After operation,the β2-MG, CEA and CA153 levels in peripheral blood in breast cancer patients were significantly lower than the preoperative levels (P<0.05).

Conclusions

Based on the level of β2-MG in peripheral blood, combined test cannot increase the sensitivity of diagnosis. The CA153 level may be useful in predicting the prognosis. There are significant differences in the levels of tumor markers between preoperative and postoperative breast cancer patients, which imply the importance of tumor markers in follow-up.

Key words: breast neoplasms, diagnosis, prognosis, β2-microglobulin, carcinoembryonic antigen, CA153, CA125
表1 肿瘤标记物在乳腺癌和健康人群中的浓度差异
肿瘤标记物 乳腺癌组[M(QR)] 健康对照组[M(QR)] 统计量a P值
β2-MG(mg/L) 1.8(1.5~2.2) 1.5(1.3~1.8) 5.42 0.00
CEA(ng/ml) 1.7(1.2~2.4) 1.2(0.9~1.9) 4.41 0.00
CA153(U/ml) 7.8(6.0~12.5) 7.3(5.6~10.6) 1.61 0.11
CA125(U/ml) 10.5(7.8~15.0) 11.1(7.7~14.4) 0.22 0.82
表2 肿瘤标记物在乳腺癌组和健康对照组的阳性率
肿瘤标记物 乳腺癌组(%) 健康对照组(%) 统计量 P值 诊断敏感性(%) 诊断特异性(%)
β2-MG 46.43(65/140) 20.83(30/144) 20.89a 0.00 46.43 79.17
CEA 3.75(5/140) 0.00(0/144) 0.03b 3.75 100.00
CA153 1.43(2/140) 0.69(1/144) 0.62b 1.43 99.31
CA125 3.75(5/140) 1.39(2/144) 0.23b 3.75 98.61
表3 肿瘤标记物与临床分期的关系
肿瘤标记物 临床分期[M(QR)] 统计量a P值
Ⅰ Ⅱ Ⅲ
β2-MG(mg/L) 1.9(1.6~2.2) 1.8(1.5~2.2) 1.8(1.5~2.0) 1.69 0.43
CEA(ng/ml) 1.7(1.3~2.2) 1.7(1.2~2.4) 1.8(1.2~2.9) 0.99 0.61
CA125(U/ml) 10.8(8.2~14.1) 9.6(7.1~15.7) 11.1(7.9~18.7) 0.67 0.71
CA153(U/ml) 6.8(5.5~10.2) 8.5(6.1~13.4) 9.2(6.7~14.4) 7.34 0.03
表4 乳腺癌患者术前术后血清肿瘤标记物浓度变化的比较
肿瘤标记物 术前[M(QR)] 术后[M(QR)] 术前术后差值[M(QR)] 统计量a P值
β2-MG(mg/L) 1.8(1.5~2.2) 1.7(1.5~2.0) -0.1(-0.3~0.1) -1743 0.00
CEA(ng/ml) 1.7(1.2~2.4) 1.4(0.9~1.9) -0.3(-0.6~0.0) -2847 0.00
CA153(U/ml) 7.8(6.0~12.5) 6.5(5.0~10.7) -1.1(-2.2~(-0.1) -3036 0.00
CA125(U/ml) 10.3(7.7~15.0) 10.0(7.0~15.0) -0.7(-2.4~1.8) -720 0.13
表5 β2-MG 为基础联合检验对乳腺癌诊断结果
检验指标 乳腺癌组[例(%)] 健康对照组[例(%)] 诊断敏感性(%) 诊断特异性(%) 统计量a P值
β2-MG 65(46.43) 30(20.83) 46.43 79.17 0.44 1.00
β2-MG+CEA 65(46.43) 30(20.83) 46.43 79.17
β2-MG+CA125 68(48.57) 32(22.22) 48.57 77.78
β2-MG+CA153 66(47.14) 31(21.53) 47.14 78.47
β2-MG+CEA+CA125 68(48.57) 32(22.22) 48.57 77.78
β2-MG+CEA+CA153 66(47.14) 31(21.53) 47.14 78.47
β2-MG+CA153+CA125 69(49.29) 33(22.92) 49.29 77.08
β2-MG+CEA+CA153+CA125 69(49.29) 33(22.92) 49.29 77.08
[1]
Leong SP, Shen ZZ, Liu TJ, et al. Is breast cancer the same disease in Asian and Western countries? [J]. World J Surg,2010,34(10):2308-2324.
[2]
Bast RC Jr, Ravdin P, Hayes DF, et al. 2000 update of recommendations for the use of tumor markers in breast and colorectal cancer: clinical practice guidelines of the American Society of Clinical Oncology [J]. J Clin Oncol,2001,19(6):1865-1878.
[3]
汤钊猷. 现代肿瘤学[M]. 第2 版. 上海:上海医科大学出版社,2000:350-356.
[4]
Arslan N, Serdar M,Deveci S,et al. Use of CA15-3,CEA and prolactin for the primary diagnosis of breast cancer and correlation with the prognostic factors at the time of initial diagnosis[J]. Ann Nucl Med,2000(5),14:395-399.
[5]
Kokko R, Holli K, Hakama M. CA15-3 in the follow-up of localised breast cancer: a prospective study [J]. Eur J Cancer,2002,38(9):1189-1193.
[6]
Duffy MJ. Serum tumor markers in breast cancer: are they of clinical value [J]. Clin Chem,2006,52(3):345-351.
[7]
Pentheroudakis G, Malamou-Mitsi V, Briasoulis E, et al. The neutrophil, not the tumor, serum CA15-3 elevation as a result of granulocyte-colony-stimulating factor-induced neutrophil MUC1 overexpression and neutrophilia in patients with breast carcinoma receiving adjuvant chemotherapy [J]. Cancer,2004,101(8):1767-1775.
[8]
Martinez-Trufero J, de Lobera AR, Lao J, et al. Serum markers and prognosis in locally advanced breast cancer [J].Tumori,2005,91(6):522-530.
[9]
张丽,佟仲生,郝春芳,等.血清CA15-3 和CEA 对转移性乳腺癌化疗疗效的预测作用[J].实用肿瘤杂志,2010(1),25:27-31.
[10]
Molina R, Barak V, van Dalen A, et al. Tumor markers in breast cancer—European Group on Tumor Markers recommendations [J]. Tumor Biol,2005,26(6):281-293.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志（电子版）, 2024, 21(11): 1089-1091.
[2] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[3] 高杰红, 黎平平, 齐婧, 代引海. ETFA和CD34在乳腺癌中的表达及与临床病理参数和预后的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 64-67.
[4] 李代勤, 刘佩杰. 动态增强磁共振评估中晚期低位直肠癌同步放化疗后疗效及预后的价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 100-103.
[5] 韩萌萌, 冯雪园, 马宁. 乳腺癌改良根治术后桡神经损伤1例[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 117-118.
[6] 熊鹰, 林敬莱, 白奇, 郭剑明, 王烁. 肾癌自动化病理诊断：AI离临床还有多远？[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 535-540.
[7] 李伟, 宋子健, 赖衍成, 周睿, 吴涵, 邓龙昕, 陈锐. 人工智能应用于前列腺癌患者预后预测的研究现状及展望[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 541-546.
[8] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[9] 郑大雯, 王健东. 胆囊癌辅助诊断研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 769-773.
[10] 王秋生. 胆道良性疾病诊疗策略[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 779-782.
[11] 王景明, 王磊, 许小多, 邢文强, 张兆岩, 黄伟敏. 腰椎椎旁肌的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 846-852.
[12] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[13] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[14] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[15] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号