Ruibal A, Garrido Pumar M, Arias J I
Servicio de Medicina Nuclear, Hospital Clínico Universitario, Santiago de Compostela, España.
Rev Esp Med Nucl. 2006 May-Jun;25(3):180-3. doi: 10.1157/13088414.
To study the possible associations between preoperative serum CEA and CA15.3 levels and different clinical-biological parameters of infiltrating ductal carcinomas of the breast (IDC).
Preoperative serum CA15.3 and CEA levels were determined in 255 and 224 females, respectively, having IDC. We assayed the cytosolic levels of estrogen receptor, pS2, cathepsin D and hyaluronic acid, as well as the levels of epidermal growth factor receptor in cell surfaces. Tumor size, axillary involvement (N), distant metastasis (M), histological grade (HG) and cellular S-phase (SP) were taken into account.
22 IDC were positive for CA15.3 (> 40 U/ml) and they had greater global tumor size (p < 0.001), > 2 cm (p: 0.005) and distant metastasis (p < 0.001). 19 IDC were positive for CEA (> 4 ng/ml) and they had greater global tumor size (p < 0.001), > 2 cm (p < 0.001), > 5 cm (p: 0.052) and global S-phase values (p: 0.062), and were more frequently N + (p: 0.045), > 3N + (p: 0.001) and > 10N + (p < 0.001), M + (p: 0.004), HG3 (p: 0.091) and SP > 7 % (p: 0.006).
Our results led us to the following: In patients having IDC of the breast, preoperative serum CA15.3 levels are associated with greater tumor size and distant metastasis, while pre-treatment CEA serum levels are associated moreover with axillary involvement; we have not observed any correlation between serum levels of both antigens and the hormonal status of the tumor; these results had physiopathological interest but reduced clinical value in pretreatment breast carcinomas due to their low sensitivity of both markers. However, they are useful in the follow-up of the patients when assessing serum concentrations of both markers, since they contribute to knowing the patients' clinical status better.
研究术前血清癌胚抗原（CEA）和糖类抗原15.3（CA15.3）水平与乳腺浸润性导管癌（IDC）不同临床生物学参数之间的可能关联。
分别对255例和224例患有IDC的女性患者测定术前血清CA15.3和CEA水平。我们检测了雌激素受体、pS2、组织蛋白酶D和透明质酸的胞质水平，以及细胞表面表皮生长因子受体的水平。考虑了肿瘤大小、腋窝淋巴结转移情况（N）、远处转移情况（M）、组织学分级（HG）和细胞S期（SP）。
22例IDC患者的CA15.3呈阳性（>40 U/ml），其肿瘤总体积更大（p<0.001），直径>2 cm（p:0.005），且有远处转移（p<0.001）。19例IDC患者的CEA呈阳性（>4 ng/ml），其肿瘤总体积更大（p<0.001），直径>2 cm（p<0.001），直径>5 cm（p:0.052），S期总体值更高（p:0.062），且更常出现N+（p:0.045）、>3N+（p:0.001）和>10N+（p<0.001），M+（p:0.004），HG3（p:0.091）和SP>7%（p:0.006）。
我们的研究结果如下：在患有乳腺IDC的患者中，术前血清CA15.3水平与更大的肿瘤大小和远处转移相关，而治疗前血清CEA水平还与腋窝淋巴结转移有关；我们未观察到两种抗原的血清水平与肿瘤激素状态之间存在任何相关性；这些结果具有生理病理学意义，但由于两种标志物的低敏感性，在乳腺癌治疗前的临床价值有限。然而，在评估患者血清中两种标志物的浓度时，它们对患者的随访有用，因为有助于更好地了解患者的临床状况。
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