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[肿瘤标志物在评估转移性乳腺癌化疗或激素治疗疗效中的随访研究]

[Follow-up of tumor markers in evaluating the effectiveness of chemo- or hormone therapy in metastatic breast cancer].

作者信息

Möbus V, Paula J, Beck T, Crombach G, Kreienberg R

机构信息

Universitäts-Frauenkliniken, Ulm.

出版信息

Geburtshilfe Frauenheilkd. 1993 Jan;53(1):24-9. doi: 10.1055/s-2007-1023632.

Abstract

We compared the course of the tumour markers CEA and CA 15-3 with the clinical course of 62 patients with metastasising breast cancer. The patients were treated by an aggressive chemotherapy (FAC-regimen) or high-dose hormonal therapy (1000 mg MPA/day). The markers were determined after a well-defined schema. In patients treated with aggressive chemotherapy, the markers were determined 4, 8 and 12 hours as well as 7 days after each course. In patients treated with hormonal therapy, the markers were determined weekly from the first to 12th week as well as 4, 8 and 12th week after onset of therapy. The course of the tumour markers was compared with the results of the radiological and clinical staging three months after beginning of therapy. For patients treated with aggressive chemotherapy CEA withdrawn 4 hours after the first and second cycle resulted in medium predictive values of 88% for marker increase and 93% for marker decrease. In comparison, the predictive values of CA 15-3 were 81% for marker increase and 71% for marker decrease. Both markers obtained better results when withdrawn four hours after therapy compared to values withdrawn 7 days after therapy. In high-dose hormonal therapy, the determination of markers collected four weeks after onset of therapy is sufficient for predicting the clinical course. The medium predictive values of CEA after 4 and 8 weeks amount to 83% for marker increase and 87% for marker decrease. In comparison, the predictive values of CA 15-3 are 95% vs. 85%.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们将62例转移性乳腺癌患者的肿瘤标志物癌胚抗原(CEA)和糖类抗原15-3(CA 15-3)的变化过程与临床病程进行了比较。这些患者接受了积极的化疗(FAC方案)或大剂量激素治疗(1000毫克甲孕酮/天)。标志物按照明确的方案进行测定。接受积极化疗的患者,在每个疗程后的4、8和12小时以及7天测定标志物。接受激素治疗的患者,在治疗开始后的第1至12周每周测定标志物,以及在治疗开始后的第4、8和12周测定。将肿瘤标志物的变化过程与治疗开始三个月后的放射学和临床分期结果进行比较。对于接受积极化疗的患者,在第一个和第二个周期后4小时采集的CEA,标志物升高的预测值为88%,标志物降低的预测值为93%。相比之下,CA 15-3标志物升高的预测值为81%,标志物降低的预测值为71%。与治疗7天后采集的值相比,治疗后4小时采集时两种标志物都取得了更好的结果。在大剂量激素治疗中,治疗开始四周后采集标志物测定足以预测临床病程。4周和8周后CEA的预测值,标志物升高为83%,标志物降低为87%。相比之下,CA 15-3的预测值分别为95%和85%。(摘要截断于250字)

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