Tjandra J J, McLaughlin P J, Russell I S, Collins J P, McKenzie I F
Department of Pathology, University of Melbourne, Parkville, Vic., Australia.
Eur J Cancer Clin Oncol. 1988 Oct;24(10):1633-40. doi: 10.1016/0277-5379(88)90056-9.
Serum levels of mammary serum antigen (MSA), beta 2-microglobulin (beta 2M) and carcinoembryonic antigen (CEA) were evaluated in 186 subjects to assess their use in the diagnosis and monitoring of breast cancer, either singly or in combination. Raised MSA levels (greater than 300 I.U.) were detected in 79% of patients with Stage I/II breast cancer, compared with 25% for beta 2M (greater than 2000 micrograms/l) and 12% for CEA (greater than 5 ng/ml) levels respectively. Of 53 patients with Stage III/IV breast cancer, 98% (MSA), 55% (beta 2M) and 64% (CEA) had raised levels. In 25 patients followed over 3-9 months, the changes in MSA levels correlated with the clinical course of the disease in 23/25 (92%), compared with 7/25 (28%) using beta 2M, and 9/25 (36%) using CEA assays. The overall sensitivity, specificity and accuracy in detecting breast cancer were 88%, 95% and 99% for MSA; 39%, 90% and 96% for beta 2M; and 38%, 95% and 98% for CEA, respectively. MSA and beta 2M assays in combination enhanced the sensitivity in the detection of breast cancer (93%) especially early breast cancer, while maintaining specificity (90%). MSA seems to be superior to beta 2M or CEA as a tumour marker in breast cancer and its levels seem to correlate with tumour burden. While it appears that beta 2M or CEA measurements used alone are of little value in the current management of breast cancer, beta 2M may be a helpful adjunct to enhance the sensitivity of MSA assay especially in early breast cancer.
对186名受试者的血清乳腺血清抗原（MSA）、β2 - 微球蛋白（β2M）和癌胚抗原（CEA）水平进行了评估，以单独或联合评估它们在乳腺癌诊断和监测中的应用。在I/II期乳腺癌患者中，79%检测到MSA水平升高（大于300国际单位），相比之下，β2M水平升高（大于2000微克/升）的患者为25%，CEA水平升高（大于5纳克/毫升）的患者为12%。在53例III/IV期乳腺癌患者中，98%（MSA）、55%（β2M）和64%（CEA）的水平升高。在25名随访3 - 9个月的患者中，MSA水平变化与疾病临床进程在23/25（92%）的患者中相关，相比之下，使用β2M的为7/25（28%），使用CEA检测的为9/25（36%）。检测乳腺癌的总体敏感性、特异性和准确性，MSA分别为88%、95%和99%；β2M分别为39%、90%和96%；CEA分别为38%、95%和98%。MSA和β2M联合检测提高了乳腺癌尤其是早期乳腺癌检测的敏感性（93%），同时保持了特异性（90%）。作为乳腺癌的肿瘤标志物，MSA似乎优于β2M或CEA，其水平似乎与肿瘤负荷相关。虽然单独使用β2M或CEA测量在当前乳腺癌管理中似乎价值不大，但β2M可能有助于提高MSA检测的敏感性，尤其是在早期乳腺癌中。
