| Objective:1. To discuss the diagnosis significance of four tumor markers (CA125, CA153, TPS and CEA) in breast cancer patients, and the relationship between breast cancer clinical various factors and pathological various subtypes.2. Comparison the clinical curative effect between Herceptin combination with TAX chemobiotherapy and EPI combination with TAX simply chemistry therapy. To discuss the relationship between the two therapy methods and the expression of Her-2/neu.3. To discuss the changes in serum tumor markers before and after Herceptin combination with TAX biochemistry therapy. To discuss the relationship between the clinical curative effect and the quantity alteration of tumor markers, and the relationship between tumor markers curative and clinical curative effect evaluation.Methods:1. Tumor markers were detected by retrospective study methods. We study and analyze 73 breast cancer patients confirmed by pathology in our hospital between June 2000 and December 2004, and 30 breast benign disease patients who havebeen accurately diagnosed and were detected tumor markers in our hospital. According to TNM staging of WHO, the I stage and 11 stage were defined as the earlier period breast cancer, the III stage and IV stage were defined as the late breast cancer. When comparing detecting rate between benign and malignant tumor markers, 103 patients were divided into benign group and malignant group. When comparing the relationship between four serum tumor markers and clinical pathology agents, according to the age of 73 breast cancer patients, they were divided into 3 groups: <35, between 35 and 50, >50. According to histological character, they were divided into five groups: duct carcinoma, lobular carcinoma, carcinoma simplex, inocarcinoma and adenocarcinoma. According to clinical stages, they were divided into I, II, III, and IV groups. The tumor markers were detected by ELISA methods. The data statistic software is SPSS10.0.2. Chemobiotherapy investigation group was 32 patients who expressed Her-2/neu and were treated with Herceptin combination with TAX in our tumor center. The control group was 41 patients who expressed Her-2/neu and were treated with EPI combination with TAX. The data statistic software is SPSS 10.0.Results:1. The research results of tumor markers about breast cancer are as follows: (D We can know from the comparison with the level of CA125, CA153> TPS and CEA during different stages, the level of CA153 between the benign group and the malignant earlier period group, between the malignant earlier period group and the malignant late period group, and between the benign group and the malignant late period group all have significant difference, p value is 0.006n 0.010> 0.000, respectively. The level of CA125 between the benign group and the malignant earlier period group, and between the benign group and the malignant late period group have significant difference,/? value is 0.006, 0.017, but have no significantdifference between the malignant earlier period group and the malignant late period group, p value is 0.384. The results of TPS were similar to the CA153, and have significant difference among each groups (p<0.05). The level of CEA is not enough sensitive between each groups, only have significance difference between the benign group and the malignant late period group, p value is 0.01, but have no significant difference between the other groups (p>0.05). (2) In 73 breast cancer patients and 30 breast benign disease patients, the Se of combination detection four serum tumor markers(90.41%) is higher than that of detection alone(52.05%> 39.73%, 78.08% and 58.90%).? Among 3 age groups, the expression levels of four serum tumor markers respectively and four index combination have no significant difference when comparing among age groups (p >0.05) . It was suggested that the proliferation condition of the four common used tumor markers in breast cancer have no relation to patients' age. ? The expression levels of four tumor markers and combination detection have no significant difference when comparing to the histological types (p>0.05) . (5) The positive rate of CA153 in breast cancer III (84.6%) is higher than that in I > IK IV. The positive rate of CA125^ TPS> CEA and four combination detection in breast cancer IV stage(52.29&N 87.0%? 73.9%, 100.0%)are all higher than I , II ^ III stage. The positive rate of four combination detection in breast cancer II ^ IIK IV are all higher than detection four tumor markers separately. The total positive rate of detection four tumor markers separately and four combination detection both have significance difference during breast tumor different stages(p<0.05) .2. To compare biochemotherapy and simple chemotherapy on clinical therapeutic effect: ?The obiective response rate and clinical benefit response of research group treated with Herceptin combined with TAX to therapy breast cancer wereobviously higher than those of control group treated with EPI combined TAX, at the same time, the invalid rate of research group was lower than that of control group. According to statistical analysis, there was a significant difference between clinical therapeutic effect of two groups(/?<0.05); ?There was a positive correlation between the therapeutic effect of biochemotherapy in breast cancer and the expression of Her-2/neu, and its clinical effective rate increased with expression rate of Her-2/neu. The clinical effective rate of Her-2/neu(+), Her-2/neu(++), Her-2/neu(+++) were 0%, 44.4% and 63.6%,respectively; however, there was no correlation between the therapeutic effect of simple chemotherapy and the expression of Her-2/neu. The clinical effective rate of Her-2/neu(+) , Her-2/neu(++), Her-2/neu(+++) are 8.3%, 36.4% , 38.9%, respectively, and there was no significant difference according to statistical analysis (p>0.05)<,3. The change of serum tumor marker before and after treatment of Herceptin combined with TAX therapy: CDAfter chemotherapy of Herceptin combined with TAX, the level of four gerenal serum tumor marker were lower than it before chemotherapy of Herceptin combined with TAX, especially there were significant difference in CA153, TPS and CEA(p<0.05), however, there was no significant difference in CA125 (p>0.05); ?The numerical value of serum tumor marker after treatment distinctly changed with therapeutic effect. There were significant difference in the variance of CA153, TPS> CEA in the groups of distinct therapeutic effect. CA153, TPS, CEA had a more superiority than CA125 in monitoring clinical therapeutic effect; ?The evaluation to therapeutic effect of tumor marker basically accorded with the evaluation to clinical therapeutic effect. The total coincidence of CA153, CA125, TPS and CEA were 59.37%, 43.75%, 53.13% and 65.63%, respectively. There were all significant difference exceptCA125 (p<0.05) . Conclusions:1.Serum tumor markers CA153^ CA125> TPS and CEA could be adjunctive diadynamic criterias of breast cancer, and if detecting all of them simultaneouly, the diagnostic value of III and IV stage of breast cancer would be higher.2.Serum tumor markers CA153^ CA125> TPS and CEA played an important role in the referenced value in judging the breast cancer 's serious conditions.3.CA153> CA125, TPS and CEA could be significance levels to evaluate breast cancer patients' prognostic conditions and detecting all of them simultaneously could make the evaluation better. If serum level of patients increased, it might prognosticate an unfavourable prognosis.4.CA153^ CA125, TPS and CEA could be levels to monitor the therapeutic effects of breast cancer patients, and evaluate their therapeutic effects.5.For the Her-2/neu high-expressed patients who were in advanced stage of breast cancer, the biotherapy therapeutic regimen which used Herceptin combined with TAX leaded a more conspicuous therapeutic effect than the simple chemotherapy plan which used EPI combined with TAX. So for the Her-2/neu high-expressed patients who were in advanced stage of breast cancer, if they had good economic strength, they'd better choose the biochemotherapeutic regimen which used Herceptin combined with TAX firstly.6.After the biochemotherapeutic plan which used Herceptin combined with TAX, the changes of breast cancer patients' tumor markers could reflect therapeutic effects partly, and after therapies,the levels of serum tumor markers all decreased at different degrees. Compared with the condition before therapies, CA153^ TPS and CEA of serum all had significant difference, while CA125 didn't have.7.Breast cancer tumor markers had great clinical value on evaluating therapeuticeffects. CA153^ TPS and CEA of serum had more advantages on monitoring the therapeutic effects of breast cancer patients and reflecting the development of patients' conditions or the good effects.8.The effective power of the Her-2/neu(+++)-breast cancer patients who were treated by Herceptin combined with TAX was higher than the Her-2/neu(++)-breast cancer patients, so for the Her-2/neu high-expressed patients who were in advanced stage of breast cancer, they'd better choose the biotherapy therapeutic regimen which used Herceptin mostly.
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