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目的:探讨局部进展期乳腺癌新辅助化疗前后血清CA15-3水平变化及其与疗效的关系。方法:2002年-2006年应用CEF(环磷酰胺+表阿霉素+氟尿嘧啶)方案对96例IIb-III期乳腺癌患者进行新辅助化疗。28天为1个周期,新辅助化疗2个周期后评价疗效。于治疗前1天及治疗2周期后采外周静脉血5ml,用电化学发光免疫法检测血清CA15-3水平。结果:新辅助化疗总有效率为47.9%(46/96),其中38例(39.6%)降低了临床分期,完全缓解7例,部分缓解39例,无疾病进展者。96例乳腺癌患者化疗前CA15-3阳性率为64.6%(62/96)。CA15-3阳性组和阴性组总有效率分别为45.2%(28/62)、52.9%(18/34),无显著性差异(P>0.05)。化疗前血清CA15-3水平为45.8±6.3;化疗后为32.5±6.8,较化疗前显著下降(P<0.05)。其中临床完全缓解和部分缓解患者血清CA15-3水平化疗后较化疗前均有一定程度下降(P<0.05);而病情稳定患者血清CA15-3水平较化疗前无显著下降(P>0.05)。结论:新辅助化疗前后血清CA15-3水平变化与临床疗效有一定的相关性,动态监测血清CA15-3可预测疗效。
Objective: To investigate the changes of serum CA15-3 level before and after neoadjuvant chemotherapy in locally advanced breast cancer and its relationship with the curative effect. Methods: A total of 96 patients with stage IIb-III breast cancer underwent neoadjuvant chemotherapy with CEF (cyclophosphamide + epirubicin + fluorouracil) from 2002 to 2006. 28 days for a cycle, neoadjuvant chemotherapy after 2 cycles to evaluate the efficacy. Peripheral venous blood was collected 5 days before treatment and 2 cycles after treatment, and serum CA15-3 level was detected by electrochemiluminescence immunoassay. Results: The total effective rate of neoadjuvant chemotherapy was 47.9% (46/96), of which 38 (39.6%) reduced the clinical stage, complete remission in 7 cases, partial remission in 39 cases and no disease progression. The positive rate of CA15-3 in 96 cases of breast cancer patients before chemotherapy was 64.6% (62/96). The total effective rates of CA15-3 positive group and negative group were 45.2% (28/62) and 52.9% (18/34) respectively, with no significant difference (P> 0.05). The level of serum CA15-3 before chemotherapy was 45.8 ± 6.3; after chemotherapy, it was 32.5 ± 6.8, which was significantly lower than that before chemotherapy (P <0.05). Serum CA15-3 levels in patients with clinically complete remission and partial remission were lower than those before chemotherapy (P <0.05), while those in patients with stable disease did not decrease significantly (P> 0.05). Conclusion: The change of serum CA15-3 level before and after neoadjuvant chemotherapy has a certain correlation with clinical curative effect. Dynamic monitoring of serum CA15-3 can predict the curative effect.