Riedinger Jean-Marc, Goussot Vincent, Desmoulins Isabelle, Lorgis Véronique, Coutant Charles, Beltjens Françoise, Lizard Sarab, Fumoleau Pierre
Centre Georges-François-Leclerc, département de biologie et pathologie des tumeurs, 1, rue de Pr.-Marion, 21079 Dijon cedex, France.
Centre Georges-François-Leclerc, département de biologie et pathologie des tumeurs, 1, rue de Pr.-Marion, 21079 Dijon cedex, France.
Bull Cancer. 2016 May;103(5):434-43. doi: 10.1016/j.bulcan.2016.02.003. Epub 2016 Mar 8.
This retrospective study evaluates the interest of CEA measurement for early detection of breast cancer recurrences. Among 804 patients with invasive breast cancer, we selected 97 patients without recurrence (WR) for 5 years or more, 32 with a local recurrence (LR) and 131 with at least one distant metastasis (DM). Elevated CEA and CA 15-3 levels (>3.1 μg/L and >26 kU/L respectively) were found in 6 % and 22 % of patients with RL respectively and in 49 % and 69 % of patients with DM. Both CEA and CA 15-3 retained a significant value in predicting DM by univariate and multivariate analysis. Higher sensitivity of CEA and CA 15-3 were found in tumors with positive hormonal receptor status. CEA and CA 15-3 levels at DM were raised respectively in 23 and 65 % of the triple negative group, 58 and 75 % of the luminal, 56 and 78 % of the luminal-HER2 and 50 and 30 % of HER2-enriched group (P=0.0094 and 0.0252 respectively). The combination of CEA and CA 15-3 increased CA 15-3 sensitivity in especially luminal and HER2-enriched groups. In conclusion, elevated CA 15-3 and CEA levels at initial diagnosis of recurrence were found to be associated with hormonal receptor status and breast cancer subtypes. The combination of CEA and CA 15-3 appeared useful especially luminal and HER2-enriched groups.
这项回顾性研究评估了癌胚抗原（CEA）检测对早期发现乳腺癌复发的意义。在804例浸润性乳腺癌患者中，我们选取了97例5年及以上无复发（WR）的患者、32例有局部复发（LR）的患者以及131例至少有一处远处转移（DM）的患者。RL患者中分别有6%和22%的患者CEA和CA 15-3水平升高（分别>3.1μg/L和>26 kU/L），DM患者中这一比例分别为49%和69%。通过单因素和多因素分析，CEA和CA 15-3在预测DM方面均具有显著意义。在激素受体状态为阳性的肿瘤中，CEA和CA 15-3具有更高的敏感性。三阴组中DM时CEA和CA 15-3水平升高的比例分别为23%和65%，管腔型为58%和75%，管腔-HER2型为56%和78%，HER2富集型为50%和30%（P值分别为0.0094和0.0252）。CEA和CA 15-3联合检测尤其在管腔型和HER2富集型组中提高了CA 15-3的敏感性。总之，复发初始诊断时CA 15-3和CEA水平升高与激素受体状态及乳腺癌亚型相关。CEA和CA 15-3联合检测似乎尤其对管腔型和HER2富集型组有用。
