COMPARISON OF CIRCULATING CA15-3 AND CARCINOEMBRYONIC ANTIGEN LEVELS IN PATIENTS WITH BREAST-CANCER
COMPARISON OF CIRCULATING CA15-3 AND CARCINOEMBRYONIC ANTIGEN LEVELS IN PATIENTS WITH BREAST-CANCER
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DOI：
10.1200/jco.1986.4.10.1542
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发表时间：
1986-10-01
影响因子：
45.3
通讯作者：
KUFE, DW
中科院分区：
文献类型：
--
作者：
HAYES, DF;ZURAWSKI, VR;KUFE, DW
免疫放射分析法（IRMA）已被用于测定与乳腺癌相关的抗原CA15 - 3的循环水平。在1050名正常对照受试者中，99人（9.4%）的血清CA15 - 3抗原水平>22 U/mL，而58人（5.5%）和14人（1.3%）的血清该抗原水平分别>25 U/mL和30 U/mL。相比之下，158名转移性乳腺癌患者中有115人（73%）的CA15 - 3水平>22 U/mL。26名仅有局部转移的患者中有13人（50%）、34名仅有骨转移的患者中有27人（79%）以及24名有肝转移的患者中有20人（83%）的CA15 - 3水平>22 U/mL。此外，31名原发性乳腺癌患者中有9人（29%）的CA15 - 3水平>22 U/mL。对同一患者群体的CA15 - 3和癌胚抗原（CEA）水平进行了比较。转移性乳腺癌患者中CA15 - 3水平升高的人数明显多于CEA水平升高的人数（P <.001）。此外，在仅有骨转移以及仅有局部转移的患者中，CA15 - 3免疫放射分析法比CEA检测更敏感。原发性乳腺癌患者中CA15 - 3水平升高的人数也明显多于CEA水平升高的人数（P <.02）。在非恶性疾病患者中CA15 - 3水平也>22 U/mL，包括25名乳腺良性疾病患者中的5人（20%）以及52名肝脏良性疾病患者中的23人（44%）。此外，在54名胃肠道（GI）恶性肿瘤患者中有24人（44%）、17名支气管肺癌患者中有12人（71%）以及44名上皮性卵巢癌患者中有29人（66%）的CA15 - 3水平>22 U/mL。连续的CA15 - 3水平与临床病程相关。21名肿瘤进展的患者中有19人（91%）的CA15 - 3水平至少增加了25%。相反，9名肿瘤消退的患者中有7人（78%）的CA15 - 3水平至少降低了50%。在27名病情稳定的患者中，16人（59%）的水平与初始CA15 - 3水平相比波动不超过±25%。这些结果表明CA15 - 3抗原是评估和监测乳腺癌患者的一个敏感标志物。
An immunoradiometric assay (IRMA) has been used to determine circulating levels of the breast cancer-associated antigen, CA15-3. Of 1,050 normal control subjects, serum from 99 (9.4%) had CA15-3 antigen levels > 22 U/mL, while that from 58 (5.5%) and 14 (1.3%) had levels > 25 U/mL and 30 U/mL, respectively. In contrast, 115 of 158 patients (73%) with metastatic breast cancer had CA15-3 levels > 22 U/mL. Thirteen of 26 patients (50%) with only local metastases, 27 of 34 (79%) of those with only bone metastases, and 20 of 24 (83%) with hepatic metastases had CA15-3 levels > 22 U/mL. Furthermore, nine of 31 patients (29%) with primary breast cancer had CA15-3 levels > 22 U/mL. CA15-3 and carcinoembryonic antigen (CEA) levels were compared for the same patient population. Significantly more patients with metastatic breast cancer had elevated CA15-3 levels than had elevated CEA levels (P < .001). Furthermore, the CA15-3 IRMA was more sensitive than the CEA assay in patients with only bone metastases, as well as those with only local metastases. Significantly more patients with primary carcinoma of the breast also had elevated CA15-3 than had elevated CEA levels (P < .02). CA15-3 levels were > 22 U/mL in patients with nonmalignant conditions, including five of 25 patients (20%) with benign breast diseases, and 23 of 52 patients (44%) with benign liver diseases. Furthermore, CA15-3 levels were also > 22 U/mL in 24 of 54 patients (44%) with gastrointestinal (GI) malignancies, 12 of 17 patients (71%) with bronchogenic carcinoma, and 29 of 44 patients (66%) with epithelial ovarian carcinoma. Serial CA15-3 levels correlated with clinical disease course. Nineteen of 21 patients (91%) with tumor progression had at least a 25% increase in CA15-3 levels. Conversely, seven of nine patients (78%) with tumor regression had at least a 50% decrease in CA15-3 levels. Among 27 patients with stable disease, 16 (59%) had levels that did not vary by more than .+-. 25% of the original CA15-3 levels. These results indicate that the CA15-3 antigen is a sensitive marker for the evaluation and monitoring of patients with breast cancer.