Biological markers in breast carcinoma: III. Clinical correlations with carcinoembryonic antigen
Biological markers in breast carcinoma: III. Clinical correlations with carcinoembryonic antigen
复制标题
乳腺癌的生物标志物：III。
作者：
D. Tormey;T. Waalkes;J. Snyder;R. Simon
用放射免疫法测定乳腺癌患者血浆CEA水平，探讨其与临床病理分期、临床肿瘤负荷、预后及受累器官部位的关系。转移性疾病83例(70.9%)，术前2例，术后1~6个月3例。2例患者术前水平升高，术后降至正常。在22/22个转移性疾病患者试验中，CEA水平的升高跟随着临床治疗反应的变化。在15个试验中，该水平随着反应而下降，在7个试验中，随着疾病的进展或复发而上升。CEA升高的发生率和定量CEA水平都随着临床肿瘤负荷的增加而增加，从术后状态到术前状态到两个或更多转移的器官部位。在有限的样本中，术前或术后CEA水平与预后之间没有明显的关系；然而，在转移性疾病中，治疗前CEA水平和GT；5 ng/ml与低应答率和早期化疗失败有关。骨转移患者CEA升高的频率最高(79%)，皮肤转移患者(52%)和乳腺转移患者(50%)CEA水平升高的频率最低。肝脏和骨性疾病的平均CEA水平也高于其他转移性病变部位。CEA水平似乎在大多数转移性疾病患者中升高，并对转移性疾病的预后有重要意义。转移性疾病患者的水平似乎反映了宿主与治疗相关的肿瘤负担，特别是在水平升高的患者。
Plasma CEA levels were evaluated by radioimmunoassay in patients with breast carcinoma in relation to clinical‐pathologic staging, clinical tumor burden, prognosis and organ sites of involvement. Elevated levels were observed in 83/117 (70.9%) patients with metastatic disease, 2/14 preoperative patients and in 3/39 one‐six month postoperative patients. Preoperative levels were elevated in two patients; the levels fell to normal after operation. Changes of elevated CEA levels followed the clinical response to therapy in 22/22 metastatic disease patient‐trials. The levels decreased with a response in 15 trials and rose with progressive disease or relapse in seven trials. The incidence of CEA elevations and quantitative CEA levels both rose with increasing clinical tumor burden from the postoperative state through the preoperative state to two or more organ sites of metastatic involvement. No relationship was demonstrable among limited samples between preoperative or postoperative CEA levels and prognosis; however, in metastatic disease, pretherapy CEA levels >5 ng/ml were associated with low response rates and early therapeutic failure to chemotherapy. The highest frequency of elevated CEA levels was observed in patients with osseous involvement (79%) and the lowest frequency with skin (52%) and breast (50%) metastases. Liver and osseous disease were also associated with higher mean CEA levels than were other sites of metastatic involvement. CEA levels appear to be elevated in the majority of patients with metastatic disease and be of prognostic importance in metastatic disease. The level in patients with metastatic disease appears to reflect the therapy‐associated tumor burden of the host, especially in patients with elevated levels.