Findeisen R, Albrecht S, Richter B, Deutschmann K, Distler W
Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Technische Universität Dresden, Germany.
Clin Chem Lab Med. 1998 Nov;36(11):841-6. doi: 10.1515/CCLM.1998.148.
Cancer antigen 15-3 (CA 15-3), carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) were measured in 679 sera of breast cancer patients and in 94 sera of women without breast cancer. The tumour markers were determined using immunoluminometric assays (ILMA). The assays are characterised by an inter-assay-imprecision and intra-assay-imprecision <4 %. The breast cancer patients were staged according to the TNM classification stage 0-IV (by UICC) in patient groups with a compatible prognosis. Median and range of each stage were investigated. The cut-off values (95th and 97.5th percentile of control group) of CA 15-3, CEA and TPA were determined; specificity, sensitivity, positive and negative predictive value (PV) and efficiency were investigated for these cut-off's and the receiver operating characteristic (ROC) curves were calculated. The differences between control group and stage 0-3 were shown as non-significant for CA 15-3 and CEA but significant for TPA. Significant differences were found in stage 4 for all three tumour markers. The three tumour markers did not have differences in specificity, positive and negative PV and efficiency. TPA and CA 15-3 demonstrated comparable results in sensitivity and ROC curve analyses. These results were better than those from CEA.
对679例乳腺癌患者的血清和94例非乳腺癌女性的血清进行癌抗原15-3(CA 15-3)、癌胚抗原(CEA)和组织多肽抗原(TPA)检测。采用免疫发光分析法(ILMA)测定肿瘤标志物。这些检测方法的批间不精密度和批内不精密度均<4%。根据国际抗癌联盟(UICC)的TNM分类标准,将乳腺癌患者分为0-IV期,各期预后相近。对各期的中位数和范围进行研究。确定CA 15-3、CEA和TPA的临界值(对照组的第95和第97.5百分位数);研究这些临界值的特异性、敏感性、阳性和阴性预测值(PV)及效率,并计算受试者工作特征(ROC)曲线。结果显示,CA 15-3和CEA在对照组与0-3期之间差异无统计学意义,但TPA差异有统计学意义。在4期,所有三种肿瘤标志物均存在显著差异。三种肿瘤标志物在特异性、阳性和阴性PV及效率方面无差异。TPA和CA 15-3在敏感性和ROC曲线分析中结果相当。这些结果优于CEA的结果。