Clinical Signifinance Of Combined Detection Of Tumor Markers In Breast Cancer

Objective:Breast carcinoma is one of the famorist carcinoma of femail ,it serious threat to women's physical and mental health,however,early surgical resection and comprehensive treatment of some breast cancer patients can achieve long-term disease-free survival, early recurrence and metastasis after breast cancer treat ment can also make part of the recurrence to obtain better results in patients,So the combine dynafic detection and analysis of the tumor markers of postoperative breast carcinoma patient have good clinical value for Breast cancer prognosis, monitor and guide the treatment of recurrent . This study retrospectively analyzed 132 cases of breast cancer patients after complete follow-up data, the combined detection of tumor markers in breast cancer and its clinical significance and prognosis.Methods:This study retrospectively analyzed in our hospital from January 2005 to December 2006 132 cases of breast cancer patients a complete follow-up data, access to all the patients previous medical history, records of patient's age, pathological type, tumor size, lymph node metastasis cases, pathological TNM stage, treatment modality, menopausal status, location and time of transfer survival, ER / PR and HER-2 expression, after one month, after six months and recurrence of serum tumor markers (CA153, CEA, CA125). Combined detection by immunohistochemistry ER, PR, HER-2, a comprehensive analysis of their expression in breast cancer cases and their relationships to explore their postoperative chemotherapy in breast cancer prognosis and the significance.Results:The median age of 50 years (31-77 years). 132 patients in this group of patients accounted for 47.0% pre-menopausal patients (62/132), 53.0% of postmenopausal patients (70/132). Pathologic TNM stage, I of 31.8% (42/132),Ⅱof 42.4% (56/132),Ⅲof 25.0% (34/132). Pathological examination showed lymph node metastasis 47.7% (63/132), patients without lymph node metastasis 56.3% (69/132). The group of 5-year recurrence-free survival in patients (RFS) 71.2% (94/132), which I in patients with 5-year RFS 88.1% (37/42),Ⅱin patients 5 years RFS73.21% (41/56 ),Ⅲin patients with 5-year RFS 47.06% (16/34).I relapsed in 38 cases of accounting for 13.2% (5 / 38),Ⅱof accounting for 39.5% (15/38),Ⅲof 51.4% (18/35). 38 cases of recurrence in patients with positive rates of CA153 relapse 47.37% (18/38); recurrence rate of 42.11% when the CEA-positive (16/38); recurrence rate of CA125 positive 39.47% (15/38), three joint detection a sensitivity of 60.53% (23/38).Local recurrence and relapse in patients with bone metastasis alone when the CA153, CEA, CA125 expression rate than visceral metastases CA153, CEA, CA125 positive expression rate, the difference was significant (P <0.05).Recurrence group patients with no recurrence after one month and six months after CEA levels were significantly different (P <0.05), recurrence of breast cancer group and the group of patients without relapse after six months, one month and CA153, CA125 There were no significant differences in levels (P> 0.05), prompted the early postoperative CEA levels may be related to prognosis. Breast cancer patients according to CEA level after one month divided into two groups, one month after CEA levels <2.5 ng / mL group and the CEA level of≥2.5 ng / mL 5-year RFS compared, postoperative CEA level of a month <2.5 ng / mL 5-year RFS than CEA level≥2.5 ug / mL group, the difference was significant (P = 0.023).Patients with lymph node metastasis month CA153, CEA mean higher than in patients without lymph node metastasis, the difference was significant (P = 0.001 and 0.04, respectively). This group of patients one month after CEA, CA125, CA153 levels remained after the pathological stage of breast cancer is related to the later stages of its higher detection value, the difference was significant (P <0.05).132 cases of breast cancer patients in the HER-2 overexpression was 23.5% (31/132), ER, and (or) PR positive expression rate was 77.3% (102/132), while negative expression rate of 22.7% (30/132), ER, and (or) PR positive expression rate was 77.3% (102/132). Recurrent group of HER-2 expression than the high non-recurrent group, two groups of HER-2 over-expression rate significantly (P <0.05). ER and the recurrent group (or) PR expression were lower than those without recurrence, but the two groups of ER and (or) PR expression was no significant difference (P = 0.123> 0.05). ER, PR-negative cancer tissues the expression of HER-2 positive rate of expression of ER, PR expression in cancer tissues, ER, PR expression and the expression of HER-2 negative correlation (X2 = 5.893, P < 0.05).Conclusion:(1) breast cancer recurrence compared with CA15-3 CEA, CA125 has a higher sensitivity, combined detection of CA153, CEA, CA125 increased the sensitivity of detection of metastatic breast cancer, for monitoring the recurrence of breast cancer has good clinical application.. (2) CA153, CEA, CA125 in patients with visceral metastasis positive rate of local recurrence and bone metastases than the obvious. (3) breast cancer patients tumor markers CA153, CEA, CA125, CEA-positive rate is not high, but the average is still with the pathological staging of breast cancer is closely related to the detection value of the later stages higher; patients with lymph node metastasis month CA153, CEA mean higher than in patients without lymph node metastasis. (4) month after CEA levels may be associated with breast cancer prognosis, metastasis and recurrence of breast cancer have a certain prediction.(5) Breast HER-2, ER, PR expression levels and prognosis of breast cancer, ER, PR expression and the expression of HER-2 negative correlation, HER-2, ER, PR can be used as an important indicator of breast cancer prognosis.