Molina R, Filella X, Alicarte J, Zanon G, Pahisa J, Munoz M, Farrus B, Ballesta A M
Laboratory of Clinical Biochemistry (Unit for Cancer Research), Hospital Clinic, Medical School, Villarroel 170, Barcelona 08036, Spain.
Anticancer Res. 2003 Mar-Apr;23(2A):1035-41.
The tumor markers, CEA and CA 15.3, were prospectively studied in the sera of 1057 untreated patients with locoregional breast cancer diagnosed from 1983 to 2001. Abnormal CEA and CA 15.3 serum levels were found in 13% and 18.8% of the patients, respectively. One tumor marker or another was abnormal in 22.8% of the patients. Both tumor markers were correlated with tumor size and nodal involvement, with significantly higher concentrations in patients with larger tumors or in patients with nodal involvement. CEA was also related to the histological type and CA 15.3 with the histological grade. Univariate prognostic evaluation showed that tumor size, nodal involvement, histological grade, steroid receptors, adjuvant treatment, CEA, CA 15.3 and treatment before surgery were prognostic factors in both disease-free survival (DFS) and overall survival (OS). Similar results were obtained in node-positive patients, with the same factors being prognostic, excluding adjuvant treatment and CA 15.3, in both DFS and OS. Multivariate analysis showed that tumor size, nodal involvement, histological grade, ER and CEA were independent prognostic factors in both DFS and OS in the whole group as well as in node-positive patients. In contrast, tumor size was the only useful parameter in the prognosis of node-negative patients. CA 15.3 was useful for prognosis (OS) in node-negative patients. In summary, tumor markers are useful tools in the prognostic evaluation of patients with breast cancer.
对1983年至2001年诊断出的1057例未经治疗的局部区域性乳腺癌患者的血清进行了前瞻性研究，检测肿瘤标志物癌胚抗原（CEA）和糖类抗原15.3（CA 15.3）。分别有13%和18.8%的患者CEA和CA 15.3血清水平异常。22.8%的患者一种或另一种肿瘤标志物异常。两种肿瘤标志物均与肿瘤大小和淋巴结受累相关，肿瘤较大或有淋巴结受累的患者其浓度显著更高。CEA还与组织学类型有关，CA 15.3与组织学分级有关。单因素预后评估显示，肿瘤大小、淋巴结受累、组织学分级、类固醇受体、辅助治疗、CEA、CA 15.3和术前治疗是无病生存期（DFS）和总生存期（OS）的预后因素。在淋巴结阳性患者中也得到了类似结果，在DFS和OS中，除辅助治疗和CA 15.3外，相同因素具有预后意义。多因素分析显示，肿瘤大小、淋巴结受累、组织学分级、雌激素受体（ER）和CEA是全组以及淋巴结阳性患者DFS和OS的独立预后因素。相比之下，肿瘤大小是淋巴结阴性患者预后的唯一有用参数。CA 15.3对淋巴结阴性患者的预后（OS）有用。总之，肿瘤标志物是乳腺癌患者预后评估的有用工具。
