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目的研究血清中CEA、CA125及CA153的水平及其变化在不可测量病灶的晚期乳腺癌患者化疗中的应用价值。方法回顾性收集在我院化疗的不可测量病灶的晚期乳腺癌患者的临床资料及化疗前后血清中CEA、CA125及CA153的检测结果,分析3种肿瘤标志物的水平及其变化与患者生存时间的相关性。结果纳入的81例患者中,54.32%(44/81)的患者3种肿瘤标志物处于正常水平(标志物阴性组),45.68%(37/81)的患者有1种或1种以上的标志物高于正常水平(标志物阳性组),标志物阴性组患者中位的无进展生存期(PFS)为19.0个月,显著长于标志物阳性组的9.8个月(P=0.007);两组患者的总生存期(OS)差异无统计学意义(51.9个月vs 37.7个月,P=0.06)。化疗后任一标志物下降Ⅱ度以上者的中位PFS显著长于下降Ⅰ度者(10.2个月vs 5.2个月,P=0.008)。结论化疗前血清中CEA、CA125及CA153升高的不可测量病灶晚期乳腺癌的无进展生存期较短,化疗后任一标志物下降Ⅱ度以上可预测该类患者无进展生存期的获益情况。
Objective To study the clinical value of serum CEA, CA125 and CA153 levels and their changes in the chemotherapy of advanced breast cancer patients with unmeasured lesions. Methods We retrospectively collected the clinical data of patients with advanced breast cancer who had not measurable lesions in our hospital and the serum levels of CEA, CA125 and CA153 before and after chemotherapy. The levels of the three tumor markers and their changes were compared with those of the patients Correlation. Results Of the 81 patients enrolled, 54.32% (44/81) of the three tumor markers were normal (negative marker group), and 45.68% (37/81) had one or more of the markers The median progression-free survival (PFS) of patients with marker negative was 19.0 months, significantly longer than that of patients with marker-positive 9.8 months (P = 0.007); both groups There was no statistically significant difference in overall survival (OS) between patients (51.9 months vs 37.7 months, P = 0.06). Median PFS was significantly longer for those with a decrease in grade II of more than one degree after chemotherapy (P <0.001 for 10.2 months vs. 5.2 months). Conclusions The progression-free survival of advanced breast cancer with a non-measurable increase of CEA, CA125 and CA153 in serum before chemotherapy is short, and the decrease of any one grade after chemotherapy by grade Ⅱ can predict the progression-free survival of these patients.