| Objective：On patients with breast cancer of serum tumor markers CEA、CA15-3level before the surgery, and postoperative follow-up after the change in the processof situation, through to the groups of breast cancer patients serum tumor markers CEA,CAl5-3levels of analysis, achieve the goal of guiding clinical studies, treatment.Methods：Retrospective analysis in January2006to August2007for the firsttime treatment are surgery and for the first time in the Liaoning Province TumorHospital,132cases of breast cancer patients.1. Clinical characteristics: Patients are female, the median age of onset are asfollows:54(28-82years); Infiltrating ductal carcinoma pathological situations:87.9%(116/132), invasive lobular carcinoma in9.09%(12/132), medullary carcinoma3.03%(4/132). The postoperative lymph node metastasis: negative44.6%(59/132):55.3%(73/132) were positive. Postoperative TNM staging result is: the Ⅰ and Ⅱ Ⅲrespectively:56.76%(75/132),43.2%(57/132). Transfer: no recurrence metastasisgroup31.81%(42/132), recurrence, metastasis rate68.18%(90/132). Recurrencemetastasis: lung16.66%(22/132),6.81%(9/132) liver and brain of1.51%(2/132),0.75%(1/132),5.3%(7/132), chest wall recurrence lymph node is3.78%(5/132).Effective treatment effect:(PR+SD)64.4%(58/90), invalid (PD),35.6%(32/90).2.Serum tumor markers: All patients were required to include measurements:preoperative and postoperative serum CEA in January a week, CA15-3level, aftercompletion of treatment after2to3months at a time; Transfer measurements need tobe increased in patients with recurrence: serum levels of tumor markers and chemotherapy patients before treatment determination value after two cycles ofchemotherapy and endocrine treatment of patients with oral endocrine therapy in twomonths after measurements.3.Grouping: Preoperative and postoperative group：Preoperative an postoperativepatients serum tumor markers in January in a week; According to the patients withpostoperative TNM staging is divided into two groups: Ⅰ and Ⅱ period, Ⅲperiod; According to postoperative pathological presence of lymph node metastasis,lymph node metastasis positive transfer and negative groups. According to whetherpatients with postoperative imaging or pathological positive results are divided into;No recurrence metastasis, recurrence metastasis group; Recurrence metastasis grouppoints: according to the transfer situation without viscera metastasis group (chest wallrecurrence, local lymph node metastasis) group, the viscera metastasisgroup.According to the treatment effect: effective (CR+PR), invalid group (PD).4.Statistical calculation：Reast cancer patients serum CEA, CAl5-3level testresults for the measurement data, the mean with mean±standard deviation. Tonormality test and f test, the results do not conform to the normal distribution orvariance not neat, so each group statistical analysis with nonparametric test. Valid andinvalid group counting the comparison of two groups of patients as treatment,chi-square test. Inspection standard (P <0.05), the difference was statisticallysignificant.Results:Reoperative and postoperative group: preoperative and postoperativepatients serum CEA level, Respectively (7.7±11.2)ng/ml,(4.6±9.03ng/ml;Preoperative and postoperative serum CAl5-3levels respectively:(28.08±39.7)u/ml,(18.3±34.09) u/ml; Higher than that of postoperative serum levels of tumormarkers preoperatively, the difference was statistically significant (P <0.05).TNM staging group: Phase Ⅰ and Ⅱ group of breast cancer patients withpreoperative and postoperative serum CEA average respectively:(9.56±10.29ng/ml),(2.43±0.49) ng/ml; CA15-3mean respectively:(23.25±22.71) u/ml,(14.25±3.71)u/ml; Ⅲ group of breast cancer patients with preoperative and postoperative CEA averages:(18.43±18.49ng/ml,(6.33±8.03) ng/ml; CA15-3preoperative andpostoperative mean respectively:(34.25±32.71) u/ml,(21.3±16.49) u/ml; P values <0.05, the difference was statistically significant.Any transfer: No transfer group: is there a transfer, no transfer group twogroups patients serum CEA averages:(41.6±71.6)ng/ml、(4.6±9.03)ng/ml, astatistically significant difference between p=0.00(p <0.05). Transfer, transfergroup CA15-3averages:(86.3+±85.3) u/ml,(37.3±34.09) u/ml), p=0.00(p <0.05), the difference was statistically significant.Presence of viscera metastasis: With viscera metastasis group: viscerametastasis group, without viscera metastasis after the transfer of serum CEA levelsrespectively:(41.6±71.6)ng/ml,(37.6±67.2)ng/ml; No statistical difference, p>0.05). The mean serum CAl5-3respectively:(87±87.09) u/ml,(75.3±75.1) u/ml;There was no statistically significant difference (P>0.05).With and without lymph node groups: Positive transfer and transfer thenegative group patients the results are as follows: the mean preoperative serum CEA,respectively:(10.3±12.4)ng/ml,(9.65±9.12) ng/ml; Postoperative respectively:(4.63±9.03)ng/ml,(3.55±6.49)ng/ml. The mean preoperative CA15-3:(31.5±41.89) u/ml,(29.1±40.14) u/ml; The mean postoperative serum CA15-3respectively:(18.37±12.76) u/ml,(16.21±9.89) u/ml; P values>0.05, there was no statisticallysignificant difference.Effective and ineffective group: The mean serum CEA before and aftertreatment in patients with effective group:(48.41±56.05)ng/m,(44.71±52.24ng/ml;CAl5-3mean respectively:(86.8±87.45) u/ml,(83.41±84.15) u/ml; Invalid set ofCEA mean respectively before and after the treatment:(49.38±57.15ng/ml),(46.74±55.86) ng/ml; CAl5-3levels mean is divided into:(87.78±88.58) u/ml,(84.1±86.15) u/ml. There was no statistically significant difference (p>0.05)..Conclusion1. Preoperative serum CEA, CAl5-3breast cancer patientspostoperative1month level significantly decreased..2. Serum CEA, CAl5-3is different in different TNM staging of breast cancerpatients, serum tumor markers in breast cancer patients with postoperative January level is associated with TNM staging.3. As a result of metastasis in clinical is not easy to find.at the sametime,because of the small sample size, this study therefore local invasion and distantmetastasis differences of conclusion of this study can be concluded.4. The level of serum CEA, CAl5-3recurrence metastasis were higher than thereis no recurrence of breast cancer metastasis of breast cancer patients, and not in thenormal range of tumor markers appear, often before the transfer of the occurrence ofclinical symptoms, therefore, early detection of recurrent transfer depends on regularmonitoring of postoperative patients with breast cancer tumor markers.5. In the chemotherapy of tumor markers increased transient theory, liver,mucositis chemotherapy side effects may be different curative effect is the reason whythere are differences in tumor markers. |
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