Stenman U H, Heikkinen R
Department I of Obstetrics and Gynaecology, Helsinki University Central Hospital, Finland.
Scand J Clin Lab Invest Suppl. 1991;206:52-9.
A considerable number of tumour markers and other laboratory tests are used for follow up and evaluation of breast cancer patients. No marker presently available is sensitive enough for early diagnosis and screening, but markers can be used to evaluate response to therapy and for early detection of a relapse. Of the markers presently available, CA 15-3 and CEA are mostly used. CA 15-3 appears to be somewhat more sensitive than CEA. When a cut-off level giving 97.5% specificity is used, the sensitivity of these assays is only about 5-25% in local disease and 50-70% in advanced disease. The combined use of these markers increase the sensitivity by 5-10%. The CA 15-3 assay measures a family of molecules called breast mucins, and several newer assays including MCA, MSA, CA 549, CA M26, CA M29 and BCM appear to measure members of the same family. The results obtained by these assays and with CA 15-3 correlate fairly well. So far none of the new assays has proven superior to CA 15-3. Of patients with advanced cancer, 20-30% are negative for the above mentioned markers. For these patients it may be worthwhile to try other markers not related with the above mentioned.
大量肿瘤标志物和其他实验室检查用于乳腺癌患者的随访和评估。目前可用的标志物均不够敏感，无法用于早期诊断和筛查，但可用于评估治疗反应和早期检测复发。在目前可用的标志物中，CA 15-3和癌胚抗原（CEA）最为常用。CA 15-3似乎比CEA稍敏感一些。当采用具有97.5%特异性的临界值时，这些检测方法在局部疾病中的敏感性仅约为5%-25%，在晚期疾病中为50%-70%。联合使用这些标志物可使敏感性提高5%-10%。CA 15-3检测可测量一类称为乳腺黏蛋白的分子，包括MCA、MSA、CA 549、CA M26、CA M29和BCM在内的几种较新的检测方法似乎也能测量同一类分子的成员。这些检测方法与CA 15-3所获得的结果相关性相当好。到目前为止，尚无一种新的检测方法被证明优于CA 15-3。在晚期癌症患者中，20%-30%对上述标志物呈阴性。对于这些患者，尝试使用与上述标志物无关的其他标志物可能是值得的。
