Ebeling F C, Schmitt U M, Untch M, Nagel D, Fateh-Moghadam A, Stieber P, Seidel D
Institute of Clinical Chemistry, Klinikum Grosshadern, Ludwig-Maximilians-University Munich, Federal Republic of Germany.
Anticancer Res. 1999 Jul-Aug;19(4A):2545-50.
Tumour markers are putative prognostic indicators for patients with breast cancer, but have not been elevated independently by multivariate analysis in a large patient number. In 550 patients with breast cancer without known metastases the levels of the serum tumour markers CEA und CA 15-3 were determined preoperatively and during follow-up. The prognostic relevance of these markers for recurrence (n = 128/487) and death of disease (n = 55/550) was evaluated in relation to established prognostic factors. In univariate analysis tumour size, lymph nodes, histological grading, age, hormone receptors, preoperative value of CEA (cut-off 2 ng/mL) and CA 15-3 (cut-off 25 U/mL) and their decrease of more than 33% within seven months after operation were significant for relapse. The results for death of disease were similar except for age. In multivariate analysis tumour size, lymph nodes and decrease of CEA > 33% (p < 0.001) were independent prognostic factors for recurrence. For overall survival tumour size, lymph nodes, histological grading and preoperative levels of CEA > or = 2 ng/mL (p = 0.038) and of CA 15-3 > or = 25 U/mL (p = 0.007) were independent prognostic factors. Pre- and postoperative values of the tumour markers CEA und CA 15-3 are strong independent prognostic factors for relapse and survival in breast cancer patients.
肿瘤标志物被认为是乳腺癌患者的预后指标,但在大量患者中,经多因素分析其并未独立升高。对550例无已知转移的乳腺癌患者,在术前及随访期间测定血清肿瘤标志物癌胚抗原(CEA)和糖类抗原15-3(CA 15-3)水平。将这些标志物与已确定的预后因素相关联,评估其对复发(n = 128/487)和疾病死亡(n = 55/550)的预后相关性。单因素分析中,肿瘤大小、淋巴结、组织学分级、年龄、激素受体、术前CEA值(临界值2 ng/mL)和CA 15-3值(临界值25 U/mL)以及术后7个月内下降超过33%对复发有显著意义。除年龄外,疾病死亡的结果相似。多因素分析中,肿瘤大小、淋巴结及CEA下降> 33%(p < )是复发的独立预后因素。对于总生存,肿瘤大小、淋巴结、组织学分级以及术前CEA≥2 ng/mL(p = )和CA 15-3≥25 U/mL(p = )是独立预后因素。肿瘤标志物CEA和CA 15-3的术前及术后值是乳腺癌患者复发和生存的强有力独立预后因素。 (注:原文中部分p值未完整给出具体数字)