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目的:分析乳腺癌脑转移患者的临床及病理资料,探讨脑转移时血清肿瘤标志CEA、CA125和CA153水平与临床病理特征和预后的相关性。方法:回顾性分析1998-04-01-2011-05-31河南省肿瘤医院及郑州大学第一附属医院收治的83例乳腺癌脑转移患者的资料,分析血清中CEA、CA125和CA153表达水平与临床病理特征的关系及预后因素分析。结果:全组中位生存时间9.6个月(0.3～32.6个月),1年生存率为41.0%,2年生存率为7.2%。血清CEA、CA125和CA153的阳性表达率分别为43.4%(36/83)、44.6%(46/83)和51.8%(43/83)。高血清CA153水平与多发脑转移有关,P<0.05;高血清CA125水平与多发脑转移、PS评分及伴发颅外转移均有关,P<0.05。血清CEA≤5ng/mL者比CEA>5ng/mL者预后好,中位生存时间分别为13.1个月和6.0个月,P=0.000;与CA125≤35U/mL相比,CA125>35U/mL者预后差,中位生存时间分别为16.8个月和6.9个月,P=0.001。多因素分析显示,PS评分、脑转移的治疗方式和CEA表达水平是影响乳腺癌脑转移患者预后的独立因素,差异均有统计学意义,P<0.05。结论:脑转移时血清CA125和CA153的表达水平与乳腺癌脑转移患者的临床病理特征有关,CEA和CA125的表达水平与预后有关,CEA是影响乳腺癌脑转移患者预后的独立预后因素,高CEA表达水平者预后较差。
OBJECTIVE: To analyze the clinical and pathological data of breast cancer patients with brain metastases and to explore the correlation between serum tumor markers CEA, CA125 and CA153 and clinicopathological features and prognosis. Methods: The data of 83 patients with brain metastases from breast cancer admitted to Cancer Hospital of Henan Province and No. 1 Affiliated Hospital of Zhengzhou University from 1998-04-01 to 2011-05-31 were retrospectively analyzed. The levels of CEA, CA125 and CA153 in serum were analyzed with Clinicopathological characteristics of the relationship and prognostic factors. Results: The median survival time was 9.6 months (0.3 ~ 32.6 months), the 1-year survival rate was 41.0% and the 2-year survival rate was 7.2%. The positive rates of serum CEA, CA125 and CA153 were 43.4% (36/83), 44.6% (46/83) and 51.8% (43/83), respectively. The serum level of CA153 was associated with multiple brain metastases, P <0.05. Serum CA125 levels were associated with multiple brain metastases, PS scores and extracranial metastases (P <0.05). Serum CEA ≤ 5ng / mL than CEA> 5ng / mL prognosis is good, the median survival time was 13.1 months and 6.0 months, P = 0.000; and CA125 ≤ 35U / mL, CA125> 35U / mL Poor prognosis, median survival time was 16.8 months and 6.9 months, P = 0.001. Multivariate analysis showed that PS score, treatment of brain metastases and CEA expression level were independent prognostic factors in patients with brain metastasis of breast cancer, the differences were statistically significant (P <0.05). CONCLUSIONS: The expression levels of serum CA125 and CA153 in brain metastases are correlated with the clinicopathological characteristics of patients with breast cancer with brain metastases. The expression levels of CEA and CA125 are related to the prognosis. CEA is an independent prognostic factor affecting the prognosis of breast cancer patients with brain metastasis. High CEA The level of expression is poor prognosis.