Wang Weigang, Xu Xiaoqin, Tian Baoguo, Wang Yan, Du Lili, Sun Ting, Shi Yanchun, Zhao Xianwen, Jing Jiexian
Department of Etiology and tumor marker laboratory, Shanxi Cancer Hospital, Shanxi Province, China.
Department of Etiology and tumor marker laboratory, Shanxi Cancer Hospital, Shanxi Province, China.
Clin Chim Acta. 2017 Jul;470:51-55. doi: 10.1016/j.cca.2017.04.023. Epub 2017 Apr 27.
This study aims to understand the diagnostic value of serum tumor markers carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA125), cancer antigen 15-3 (CA15-3), and tissue polypeptide-specific antigen (TPS) in metastatic breast cancer (MBC). A total of 164 metastatic breast cancer patients in Shanxi Cancer Hospital were recruited between February 2016 and July 2016. 200 breast cancer patients without metastasis in the same period were randomly selected as the control group. The general characteristics, immunohistochemical, and pathological results were investigated between the two groups, and tumor markers were determined. There were statistical differences in the concentration and the positive rates of CEA, CA19-9, CA125, CA15-3, and TPS between the MBC and control group (P<0.05). The highest sensitivity was in CEA and the highest specificity was in CA125 for the diagnosis of MBC when using a single tumor marker at 56.7% and 97.0%, respectively. In addition, two tumor markers were used for the diagnosis of MBC and the CEA and TPS combination had the highest diagnostic sensitivity with 78.7%, while the CA15-3 and CA125 combination had the highest specificity of 91.5%. Analysis of tumor markers of 164 MBC found that there were statistical differences in the positive rates of CEA and CA15-3 between bone metastases and other metastases (χ=6.00, P=0.014; χ=7.32, P=0.007, respectively). The sensitivity and specificity values of the CEA and CA15-3 combination in the diagnosis of bone metastases were 77.1% and 45.8%, respectively. The positive rate of TPS in the lung metastases group was lower than in other metastases (χ=8.06, P=0.005).There were significant differences in the positive rates of CA15-3 and TPS between liver metastases and other metastases (χ=15.42, P<0.001; χ=9.72, P=0.002, respectively). The sensitivity and specificity of the CA15-3 and TPS combination in the diagnosis of liver metastases were 92.3% and 45.6%, respectively, and the positive rate of CEA in triple-negative metastatic breast cancer is lower than in other subtypes (χ=4.80, P=0.028). Therefore, serum CEA, CA19-9, CA125, CA15-3, and TPS can be used in the diagnosis of MBC, and different combinations of tumor markers have varying diagnostic value.
本研究旨在了解血清肿瘤标志物癌胚抗原(CEA)、癌抗原19-9(CA19-9)、癌抗原125(CA125)、癌抗原15-3(CA15-3)和组织多肽特异性抗原(TPS)在转移性乳腺癌(MBC)中的诊断价值。2016年2月至2016年7月期间,山西医科大学第四医院共招募了164例转移性乳腺癌患者。同期随机选取200例无转移的乳腺癌患者作为对照组。调查两组患者的一般特征、免疫组化及病理结果,并测定肿瘤标志物。MBC组与对照组CEA、CA19-9、CA125、CA15-3和TPS的浓度及阳性率比较,差异有统计学意义(P<0.05)。单独使用肿瘤标志物诊断MBC时,CEA的敏感性最高,为56.7%,CA125的特异性最高,为97.0%。此外,采用两种肿瘤标志物联合诊断MBC时,CEA与TPS联合的诊断敏感性最高,为78.7%,而CA15-3与CA125联合的特异性最高,为91.5%。对164例MBC患者的肿瘤标志物分析发现,骨转移与其他转移灶之间CEA和CA15-3的阳性率差异有统计学意义(χ=6.00,P=0.014;χ=7.32,P=0.007)。CEA与CA15-3联合诊断骨转移的敏感性和特异性分别为77.1%和45.8%。肺转移组TPS的阳性率低于其他转移灶(χ=8.06,P=0.005)。肝转移与其他转移灶之间CA15-3和TPS的阳性率差异有统计学意义(χ=15.42,P<0.001;χ=9.72,P=0.002)。CA15-3与TPS联合诊断肝转移的敏感性和特异性分别为92.3%和45.6%,三阴性转移性乳腺癌中CEA的阳性率低于其他亚型(χ=4.80,P=0.028)。因此,血清CEA、CA