Also Known As
CA-乳腺
癌抗原-乳腺
正式名称
癌抗原15-3
本文最后审核 时间
本文 最后修改 时间 2018/01/01.
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为何检测?

监测乳腺浸润性癌患者对疗效的反应以及癌症是否复发。

何时检测?

乳腺浸润性癌的治疗中和治疗后。

何种样本?

自肘静脉采集血液样本。

是否需要做试验前准备?

不需要。

检测什么?

CA15-3是胸腺细胞的正常产物。由通常高由表达于乳腺癌的基因编码产生,致使发生该病变时CA15-3和CA27.29(用不同方法检测的标志物)水平升高。CA15-3并不能引起癌症,它是癌细胞脱落的蛋白。在癌症治疗过程中,作为肿瘤标志物来使用是非常有用的。

        CA15-3在大约30%的局限性乳腺癌中升高,在约75%发生转移的乳腺癌中升高。一些健康人和患有其他疾病(例如:结肠癌、肺癌、肝炎、肝硬化、良性胸部肿瘤)也可能升高。

测试样本如何采集?

自肘静脉采集血液样本。

是否需要进行任何试验前准备以保证样本的质量?

不需要试验前准备。

Accordion Title
常见问题
  • 有何用途?

    CA15-3的敏感性和特异性还不足以用于人群癌症的筛查指标。它作为肿瘤标记物监测乳腺浸润性癌患者对治疗的反应情况以及是否复发。如果癌细胞导致CA15-3水平升高,它可以作为标志物来使用,然而只有小部分局限性乳腺癌患者会有CA15-3水平的升高,但此后它仍可以作为标志物来使用。有时医生也通过测定CA 15-3大体了解此时癌块的大小。

  • 何时检测?

    当首次被诊断进展期乳腺癌时,为了明确癌症的特征和处理措施,在CA15-3水平检测的同时还进行其他实验包括:雌孕激素受体,Her2/neu 、BRCA-1、 BRCA-2基因型测定。如果CA15-3水平最初是升高的,可以用其来监测治疗情况。如果治疗后CA15-3水平围绕基线规律性变化,可以用其监测癌症的复发。CA15-3检测并不应用于早期的未发生转移的乳腺癌,因为大多数此类患者CA15-3水平并不升高。

  • 试验结果的含义?

    通常CA15-3水平越高,乳腺癌的侵袭性越强,肿瘤的负荷越大。伴随癌症生长,CA15-3水平也会升高。当乳腺癌发生骨转移或肝转移后CA15-3水平会急剧升高。

            缓慢的或微量的CA15-3水平升高见于一系列情况包括:胰腺癌、肝癌、肝硬化、良性乳腺疾病和一部分正常人。在非癌性情况下,CA15-3的升高水平是趋于稳定的 。

            CA15-3水平正常时并不能保证不患有癌症。可能因为CA15-3水平升高不够迅速而无法检测到。另外,大约25%-30%进展期乳腺癌患者癌细胞并不脱落CA15-3蛋白。

  • 还有什么我需要了解的吗?

    乳腺癌治疗初期,CA15-3水平并不会立刻下降。有的病例CA15-3水平出现一过性的升高或降低而与癌症进程不相关。通常,医生会在开始治疗几周后再监测CA15-3水平。

  • 在检测CA15-3的同时还要检测CA27.29么?

            CA27.29 是MUC1基因编码的除CA15-3外的另一种蛋白质,二者具有相同的使用范围。CA27.29比CA15-3要新,但大多数医生认为它与CA15-3是等效的,它可以用来代替CA15-3检测而不需要同时检测两项。

  • 我有乳腺癌家族史,需要进行CA15-3的筛查么?

            不推荐使用CA15-3作为筛查工具。它的敏感性和特异性还不足以用于发现早期乳腺癌。使CA15-3升高的因素有很多,另外即使是阴性结果也不排除有癌症。它仅应用于确诊的乳腺癌患者。

  • 怎样降低我的CA15-3水平?

            没有可以直接降低CA15-3水平的措施。它并不是风险因子(例如胆固醇,可以通过节食和运动来降低),而是您身体所处状态的反映。肿瘤生长时,CA15-3可能升高,治疗后可能降低,另外在某些良性疾病中,它可能微量升高或保持稳定。

View Sources

Sources Used in Current Review

Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 214-215.

Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 247.

Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 206-207.

(Revised 2008 December 08). Tumor Markers. American Cancer Society [On-line information]. Available online at http://www.cancer.org/docroot/PED/content/PED_2_3X_Tumor_Markers.asp?sitearea=PED through http://www.cancer.org. Accessed August 2009.

(Updated 2009 May) Tumor Markers. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/resources/print/TumorMarkers.pdf through http://www.arupconsult.com. Accessed August 2009.

Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER and Bruns DE, eds. 4th ed. St. Louis, Missouri: Elsevier Saunders; 2006, Pp 770-771.

Park, B et al. Preoperative CA 15-3 and CEA serum levels as predictor for breast cancer outcomes. Annals of Oncology 2008 19(4):675-681. Available online at http://annonc.oxfordjournals.org/cgi/content/full/19/4/675 through http://annonc.oxfordjournals.org. Accessed September 2009.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

Check, W. (1998 July) Reaching agreement on tumor markers. CAP Today, In the News [On-line journal]. Available online at http://www.cap.org/captoday/archive/1998/julycover.html through http://www.cap.org.

NCI (1998 April 27). Tumor markers. National Cancer Institute, Cancer Facts [On-line information]. Available online at http://cis.nci.nih.gov/fact/5_18.htm through http://cis.nci.nih.gov.

ACS (2000 July 19). Tumor Markers. American Cancer Society, Prevention and Early Detection [On-line information]. Available online through http://www.cancer.org.

AACC (2001 July 27) Use of Tumor Markers in Cancer Patients Leads to Better Detection, Decreasing Mortality. AACC Media Center, American Association for Clinical Chemistry [On-line press release]. PDF available for download at http://www.aacc.org/media/TumorMarkers.pdf through http://www.aacc.org.

ASCO (1996 May 17, adopted, revision every 3 years). CA 15-3 as a Marker for Breast Cancer. American Society for Clinical Oncologists, Clinical Practice Guidelines for the Use of Tumor Markers in Breast and Colorectal Cancer [On-line guidelines]. Available online at http://www.asco.org/prof/pp/html/guide/tumor/m_tumor10.htm through http://www.asco.org.

Merck (2000). Cancer and the Immune System. The Merck Manual of Medical Information Home Edition, Section 15 Cancer, Ch 163 [On-line information]. Available online at http://www.merck.com/pubs/mmanual_home/sec15/163.htm through http://www.merck.com.

Duffy, M. (1999). CA 15-3 and related mucins as circulating markers in breast cancer. Ann Clin Biochem [On-line journal]. Vol 36: 579-586. PDF available for download at http://www.leeds.ac.uk/acb/annals/annals_pdf/Sept%2099/ACB579.PDF through http://www.leeds.ac.uk.

Srirangam, S. and Harland, R. (2001). Management of Advanced Breast Cancer. Forum for Registrars In Surgical Training [On-line information]. PDF available for download at http://www.frist.org/asit/meetings/yearbook2001/BREAST%20CANCER.pdf through http://www.frist.org.