血清肿瘤标记物与 HER2阳性乳腺癌骨转移的相关性研究

摘要

Objective To investigate the association between tumor marker level and bone metastasis in HER 2‐positive breast cancer .Methods One hundrend patients with HER2‐positive breast cancer were collected and divided into the bone metastasis group(n=40) and non‐bone metastasis group(n=60) .The enzyme‐linked immunosorbent assay(ELISA) was adopted to monitor serum CA153 and CEA levels at admission and at the time for discovering bone metastasis .The age ,pathological classification ,and application situation of serum tumor marker and herceptin were observed .The differences of above indicators were compared be‐tween the two groups .The receiver‐operating characteristic (ROC) curve was used to evaluate the value of serum CA 153 and CEA for predicting bone metastasis in HER2‐positive breast cancer .Results The levels of serum CEA and CA153 at admission had no statistically significant difference between with and without bone metastasis in the patients with HER 2 positive breast cancer .The ROC curve showed that the levels of serum CEA (AUC 0 .72 ,95% CI 0 .72 to 0 .63 ,P=0 .01) and CA153 (AUC 0 .67 ,95% CI 0 .67 to 0 .60 ,P=0 .03) were the factors for predicting bone metastases .The sensitivity and specificity of CA153>17 .2 U/mL for predicting bone metastases were 78 .8% and 45 .0% respectively ;the sensitivity and specificity of CEA >2 .64 μg/L for predicting bone metastases were 75 .8% ,and 43 .3% ,respectively .Conclusion The serum CEA and CA153 levels have a certain value for pre‐dicting bone metastasis in the patients with HER2度positive breast cancer .%目的：观察人类表皮生长因子受体2（H ER2）阳性乳腺癌的肿瘤标记物水平与骨转移的相关性。方法收集确诊为HER2阳性浸润性乳腺癌的100例患者，根据有无骨转移分为2组：骨转移组（n＝40），未骨转移组（n＝60）。采用ELISA法监测患者入院时、随访发生骨转移时血清糖类抗原（CA153）和癌胚抗原（CEA）水平，观察2组患者年龄、病理分型、血清肿瘤标记物和赫赛汀的应用情况等，比较2组患者上述指标的差异。采用受试者工作特征（ROC）曲线预测血清CA153、CEA对 HER2阳性乳腺癌骨转移的价值。结果 HER2阳性乳腺癌患者中，骨转移组和未骨转移组入院时血清CEA、CA153水平差异无统计学意义（P＞0．05），ROC曲线发现血清CEA水平（AUC 0．72，95％ CI 0．63～0．81，P＝0．01）和CA153水平（AUC 0．67，95％ CI 0．60～0．77，P＝0．03）为预测预测骨转移的因素。其中CA153＞17．2 U／mL预测HER2阳性乳腺癌患者骨转移的敏感度为78．8％，特异度为45．0％；CEA＞2．64μg／L预测骨转移的敏感度为75．8％，特异度为43．3％。结论血清CA153和CEA水平对 HER2阳性乳腺癌的骨转移有一定的预测价值。