Prognostic Values Of Preoperative Serum CEA And CA125 Levels And Nomograms For Young Breast Cancer Patients
Prognostic Values Of Preoperative Serum CEA And CA125 Levels And Nomograms For Young Breast Cancer Patients
复制标题
年轻乳腺癌患者术前血清 CEA 和 CA125 水平及列线图的预后价值
DOI：
10.2147/ott.s221335
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发表时间：
2019-01-01
影响因子：
4
通讯作者：
Wang, Bin
中科院分区：
文献类型：
--
作者：
Li, Xuan;Dai, Danian;Wang, Bin
背景：与老年患者相比，年轻乳腺癌患者在总生存期（OS）和局部-区域无衰竭生存期（local -regional failure-free survival）方面预后较差。癌胚抗原（CEA）和癌抗原125 （CA125）已被广泛使用，但其在年轻乳腺癌患者中的预后价值尚不清楚。本研究的目的是评估术前CEA和CA125血清水平的预后价值，并建立使用这两种肿瘤标志物更好地预测中国年轻乳腺癌患者预后的nomogram。方法收集576例确诊年龄≤40岁的年轻乳腺癌患者的术前资料。用受试者工作特征（ROC）曲线确定CEA和CA125的最佳临界值。采用单因素和多因素分析确定影响总生存期（OS）和无病生存期（DFS）的相关风险因素，并根据这些确定的因素构建nomogram。结果年轻乳腺癌患者CEA和CA125的最佳临界值分别为3.38 ng/mL和19.38 U/mL。Kaplan-Meier分析显示CEA和/或CA125水平较低的年轻患者有较长的OS和DFS。多因素分析表明，CEA和CA125水平是OS的独立预测因素。建立了nomogram，对年轻乳腺癌患者的OS （AUC = 0.856）和DFS （AUC = 0.702）有较好的预测能力。结论术前血清CEA和CA125水平可能是预后OS的独立因素，包含这两个变量的nomogram预后图提供了更多的个人预测信息，帮助医生更好地优化年轻乳腺癌患者的治疗方案。
Background Young breast cancer patients have poor prognosis compared to older patients in both overall survival (OS) and loco-regional failure-free survival. Carcinoembryonic antigen (CEA) and Cancer antigen 125 (CA125) have been widely used, but their prognostic value in young breast cancer patients remains unknown. The objectives of this study were to evaluate the prognostic value of preoperative CEA and CA125 serum levels and to build nomograms for better prognostic prediction of young Chinese breast cancer patients using both tumor markers. Methods We included 576 young breast cancer patients (≤40 years at diagnosis) and collected their preoperative information. The best cut-off values of the CEA and CA125 were identified with receiver operating characteristic (ROC) curves. Univariate and multivariate analyses were used to identify the relative risks of factors for the overall survival (OS), and disease-free survival (DFS), and nomograms were constructed based on these identified factors. Results The best cut-off values for CEA and CA125 in young breast cancer patients was 3.38 ng/mL and 19.38 U/mL, respectively. Kaplan-Meier analysis showed that young patients with low levels of CEA and/or CA125, had longer OS and DFS. Multivariate analysis suggested that both CEA and CA125 levels were independent predictive elements for OS. Nomograms were built and showed a better predictive ability for OS (AUC = 0.856) and DFS (AUC = 0.702) in young breast cancer patients. Conclusion Preoperative serum CEA and CA125 levels could be the independent prognostic factors for OS, and the nomograms including these two variables provide more personal forecasts information to help physicians optimize treatment for young breast cancer patients better.