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目的观察可溶性血管细胞粘附分子-1(sVCAM-1)和癌相关糖蛋白抗原(CA15-3)在乳腺癌患者化疗前后浓度的变化,探讨二者水平与临床分期、转移部位的关系,并初步探讨晚期转移性乳腺癌患者治疗效果与二者水平变化的关系。方法采用酶联免疫吸附试验(ELISA)和化学发光免疫法(CLIA)测定15例健康人、30例早期乳癌患者(Ⅰ、Ⅱ)、40例晚期乳癌患者(Ⅲ、Ⅳ)化疗前后sVCAM-1、CA15-3血清水平。结果治疗前,Ⅰ、Ⅱ期乳腺癌患者血清sVCAM-1和CA15-3浓度与健康者比较差异无显著性(P>0.05);Ⅲ、Ⅳ期乳腺癌患者血清sVCAM-1和CA15-3浓度均显著高于健康者,并随着分期渐晚二者浓度逐渐升高,差异有显著性(P<0.05),其中,乳腺癌患者各组血清CA15-3阳性率均显著高于正常对照组(P<0.05)。检测了12例内脏转移和7例骨转移晚期乳腺癌患者血清sVCAM-1和CA15-3水平,发现内脏转移组二者水平高于骨转移组,但差异无显著性(P>0.05)。治疗后,各乳腺癌患者组血清sVCAM-1和CA15-3水平均较前降低,Ⅰ、Ⅱ组差异无显著性,Ⅲ、Ⅳ组差异显著(P<0.05),转移复发乳腺癌患者下降尤为明显。24例晚期转移患者采用以TA为主的联合方案化疗,治疗后19例患者疗效评价为PR+CR,化疗后sVCAM-1和CA15-3水平均下降,差异显著(P<0.001)。结论乳腺癌患者血清sVCAM-1和CA15-3水平与病期早晚及治疗反应相关,与转移部位关系不明显,二者有可能成为评价乳腺癌临床分期和血清学疗效的指标。
Objective To investigate the changes of soluble vascular cell adhesion molecule-1 (sVCAM-1) and cancer-associated glycoprotein antigen (CA15-3) in patients with breast cancer before and after chemotherapy, and to explore the relationship between serum VCAM-1 and clinical stage and metastatic sites Preliminary study of the relationship between the treatment effect and the changes of the two levels in patients with advanced metastatic breast cancer. Methods Serum levels of sVCAM-1 in 15 healthy individuals, 30 patients with early breast cancer (Ⅰ, Ⅱ) and 40 patients with advanced breast cancer (Ⅲ, Ⅳ) before and after chemotherapy were measured by enzyme linked immunosorbent assay (ELISA) and chemiluminescence immunoassay , CA15-3 serum levels. Results Before treatment, the serum concentrations of sVCAM-1 and CA15-3 in patients with stage I and II breast cancer had no significant difference (P> 0.05). The serum levels of sVCAM-1 and CA15-3 in stage III and IV breast cancer patients (P <0.05). The positive rate of serum CA15-3 in each group of breast cancer patients was significantly higher than that of the normal control group (P <0.05). The serum levels of sVCAM-1 and CA15-3 in 12 patients with visceral metastases and 7 patients with advanced bone metastases were detected. The levels of serum sVCAM-1 and CA15-3 were higher in visceral metastasis group than in bone metastasis group, but the difference was not significant (P> 0.05). After treatment, the levels of serum sVCAM-1 and CA15-3 in each breast cancer patient group were lower than those in the former group, but there was no significant difference between Ⅰ and Ⅱ group (P <0.05), especially in patients with metastatic breast cancer obvious. Twenty-four patients with late-stage metastasis underwent TA-based chemotherapy. The efficacy of the chemotherapy was evaluated as PR + CR in 19 patients, and the levels of sVCAM-1 and CA15-3 decreased after chemotherapy (P <0.001). Conclusion The serum levels of sVCAM-1 and CA15-3 in patients with breast cancer are related to the early and late stages of disease and the response to treatment, and have no obvious relationship with the metastatic sites. Both of them may become the indexes to evaluate the clinical stage and serological efficacy of breast cancer.