Prospective Evaluation of Carcinoembryonic Antigen (CEA) and Carbohydrate Antigen 15.3 (CA 15.3) in Patients with Primary Locoregional Breast Cancer
Prospective Evaluation of Carcinoembryonic Antigen (CEA) and Carbohydrate Antigen 15.3 (CA 15.3) in Patients with Primary Locoregional Breast Cancer
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DOI：
10.1373/clinchem.2009.135566
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发表时间：
2010-07-01
影响因子：
9.3
通讯作者：
Velasco, Martin
中科院分区：
文献类型：
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作者：
Molina, Rafael;Auge, Jose M.;Velasco, Martin
背景技术背景：癌胚抗原（CEA）和糖链抗原15.3的应用方法：我们前瞻性地研究了1984年至2008年诊断的2062例未经治疗的原发性乳腺癌患者血清中CEA和CA 15.3。CEA（>5 μ g/L）和CA 15.3（>30 kU/L）浓度升高分别见于12.7%和19.6%的患者，28%（570/2062）的患者1种或两种肿瘤标志物升高。每种肿瘤标志物的增加与较大的肿瘤大小和淋巴结受累相关。通过多变量分析，肿瘤大小、雌激素受体（ER）和CEA是总组[无病生存期（DFS）和总生存期（OS）]以及淋巴结阳性（NP）和淋巴结阴性（NN）患者的独立预后因素。淋巴结受累和组织学分级是总组和NP患者的独立预后因素。相比之下，辅助治疗和CA 15.3仅在NN患者中是独立的预后因素（DFS和OS）。所有CEA >7.5 μ g/L的患者在随访期间均复发。使用这两种肿瘤标志物允许歧视的T1 NN患者的风险组：56.3%的复发时，看到1个或两个肿瘤标志物增加，而只有9.4%的复发T1 NN患者没有增加任何marker.CONCLUSIONS：CEA和CA 15.3是有用的预后因素在NP和NN乳腺癌患者。CEA >7.5 g/L与亚临床转移的高概率相关。(c)2010年美国临床化学协会
BACKGROUND: The utility of carcinoembryonic antigen (CEA) and carbohydrate antigen 15.3 (CA 15.3) as prognostic factors in primary breast cancer is unclear.METHODS: We prospectively studied CEA and CA 15.3 in the sera of 2062 patients with untreated primary breast cancer diagnosed between 1984 and 2008.RESULTS: Increased CEA (>5 mu g/L) and CA 15.3 (>30 kU/L) concentrations were found in 12.7% and 19.6% of the patients, respectively, and 1 or both tumor markers were increased in 28% (570 of 2062). Increases in each tumor marker correlated with larger tumor sizes and nodal involvement. Tumor size, estrogen receptor (ER), and CEA were independent prognostic factors by multivariate analysis in the total group [disease free survival (DFS) and overall survival (OS)] as well as in node-positive (NP) and node-negative (NN) patients. Nodal involvement and histological grade were independent prognostic factors in the total group as well as in NP patients. By contrast, adjuvant treatment and CA 15.3 were independent prognostic factors only in NN patients (DFS and OS). All patients with CEA >7.5 mu g/L had recurrence during follow-up. Use of both tumor markers allowed discrimination of the groups of risk in T1 NN patients: 56.3% of recurrences were seen when 1 or both tumor markers were increased, whereas only 9.4% of recurrences were seen in T1 NN patients without increases of either marker.CONCLUSIONS: CEA and CA 15.3 are useful prognostic factors in NP and NN breast cancer patients. CEA >7.5 g/L is associated with a high probability of subclinical metastases. (c) 2010 American Association for Clinical Chemistry