Merimsky O, Inbar M, Hareuveni M, Witenberg B, Wolman Y, Chaitchik S
Department of Oncology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Eur J Cancer. 1991;27(11):1440-4. doi: 10.1016/0277-5379(91)90027-b.
Mucin-like carcinoma-associated antigen (MCA) was serially assayed in 58 women with histologically proven breast cancer after their treatment for primary disease. MCA sensitivity and specificity were 87.5% and 76.9%, respectively, and the positive predictive value 82.4%. 10 patients had elevated MCA and no evidence of disease (NED) during their follow-up, of whom 4 finally developed overt metastases. The 4 had a mean (S.D.) MCA value of 46.48 (18.26) U/ml during the lead time, versus 18.76 (2.69) U/ml in the other 6, who are still at high risk for developing overt metastases. Raised levels of MCA in patients with NED create a dilemma of "treat" versus "wait and see". Early treatment of patients with serially uprising MCA levels should be evaluated in a prospective randomised study to assess its ability to prevent or delay the development of overt metastatic disease and influence survival.
对58例经组织学证实患有乳腺癌的女性患者在其原发性疾病治疗后进行了黏液样癌相关抗原（MCA）的系列检测。MCA的敏感性和特异性分别为87.5%和76.9%，阳性预测值为82.4%。10例患者在随访期间MCA升高且无疾病证据（NED），其中4例最终出现明显转移。这4例患者在提前期的MCA平均（标准差）值为46.48（18.26）U/ml，而另外6例仍有发生明显转移高风险的患者该值为18.76（2.69）U/ml。NED患者中MCA水平升高造成了“治疗”与“观察等待”的两难局面。应在前瞻性随机研究中评估对MCA水平持续升高患者的早期治疗，以评估其预防或延迟明显转移性疾病发生及影响生存的能力。
