摘要
目的探讨不同分子分型乳腺癌患者血清肿瘤标志物CEA、CA125和CA15-3的表达差异,以及其与复发转移的相关性。方法回顾性分析212例乳腺癌患者的病历及随访资料,并根据激素受体表达情况分为Luminal A型、Luminal B型、Her-2过表达型和Basal-like型4个分子亚型。比较不同分子分型乳腺癌患者术前血清肿瘤标志物CEA、CA125和CA15-3的表达水平及其临床特征,并分析影响乳腺癌患者复发转移的因素。结果不同分子分型的乳腺癌患者各肿瘤标志物的表达水平存在差异,其中,Her-2过表达型患者CA15-3的表达水平较其他3组明显升高(χ^2=7.98,P=0.04)。此外,不同分子分型乳腺癌患者肿瘤细胞的分化程度不同,Her-2过表达型患者低分化的比例明显高于其他3组(χ^2=12.42,P=0.006)。4个亚组间的复发转移率也存在明显差异,Her-2过表达型患者的复发转移率最高(F=8.69,P=0.034)。多因素Cox回归分析显示,肿瘤直径、组织分化程度和有无脉管瘤栓是乳腺癌患者复发转移的独立危险因素(P均<0.05)。结论Her-2过表达型乳腺癌患者CA15-3水平高,预后差,提示临床应该结合分子分型、肿瘤标志物以及相关危险因素进行个体化治疗。
Objective To investigate the expression differences of serum tumor markers,such as CEA,CA125 and CA15-3,in different molecular subtypes of breast cancer and their correlations with recurrence and metastasis.Methods The medical records and follow-up data from 212 patients with breast cancer were retrospectively analyzed.According to the expression of hormone receptor,breast cancer were divided into four molecular subtypes:Luminal A,Luminal B,Her-2 overexpression and Basal-like.The clinical characteristics and levels of CEA,CA125 and CA15-3 in different molecular subtypes of breast cancer patients before operation were compared,and the factors influencing the recurrence and metastasis of breast cancer were analyzed.]Results There were differences in the expression levels of tumor markers for different molecular subtypes of breast cancer.The expression levels of CA15-3 in patients with Her-2 overexpression were significantly higher than that with Luminal A,Luminal B or Basal-like(χ^2=7.98,P=0.04).The differentiation degree of tumor cells in different molecular subtypes of breast cancer was different,and the proportion of low differentiation in the patients with Her-2 overexpression was significantly higher than that with Luminal A,Luminal B or Basal-like(χ^2=12.42,P=0.006).There was also differences in the recurrence and metastasis of tumor for 4 subtypes of breast cancer,and the highest recurrence and metastasis rate existed in the patients with Her-2 overexpression(F=8.69,P=0.034).The multivariate Cox regression analysis showed that tumor diameter,degree of tissue differentiation and presence or absence of vascular tumor thrombus were independent risk factors for the recurrence and metastasis of breast cancer patients(all P<0.05).Conclusion The breast cancer patients with Her-2 overexpression have high levels of CA15-3 and poor prognosis,which suggests that the individualized treatment of breast cancer should be combined with molecular subtyping,tumor markers and related risk factors.
作者
成祥君
杨璐
张伟
张洁心
衣鲁江
潘世扬
CHENG Xiangjun;YANG Lu;ZHANG Wei;ZHANG Jiexin;YI Lujiang;PAN Shiyang(Department of Laboratory Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)
出处
《临床检验杂志》
CAS
2019年第12期893-896,共4页
Chinese Journal of Clinical Laboratory Science
基金
国家自然科学基金(81672100)
江苏省实验诊断学重点实验室
国家临床重点专科建设项目
江苏省卫生计生委科研课题(H201609)
关键词
乳腺癌
肿瘤标志物
分子分型
复发转移
breast cancer
tumor marker
molecular subtype
recurrence and metastasis
作者简介
成祥君,1982年生,女,主管技师,研究方向:肿瘤分子诊断;通信作者:潘世扬,主任医师,博士,E-mail:sypan@njmu.edu.cn。
