| Objective: Many tumor markers have been used in the diagnosis and treatment of breast cancer. Recently the most widely used of them are CEA and CA15-3. Carbohydrate antigen 15-3 (CA15-3) is also known as MUCI or polypeptide of the epithelial mucin. It only expresses on the top of the glandular epithelial cells in normal circumstances. When the car-cinogenesis happens, CA15-3 is over expressed in the breast gland epithelial cells and easy to litter from the cells'surface, resulting in the CAl5-3 levels in serum increasing. Therefore, in different clinical stages, before and after operation and also in the recurrence/metastasis patients, the CA15-3 is different in serum. But CA15-3 is also widespread in other epithelial cell tumors besides breast cancer. Therefore, a single test of CA15-3 has some limitations in clinical use. Carcinoembryonic antigen (CEA) is a polysaccharide protein complex. Studies have found that the serum CEA levels of breast cancer patients are associated with the tumor progression. But as a non-specific tumor marker, the CEA can express in colorectal cancer, stomach cancer, pancreatic cancer, lung cancer, breast cancer and the majority of adenocarcinoma. Although they are commonly used as serum tumor marker of breast cancer in clinical to provide assistance for diagnosis and efficacy evaluation and postoperative follow-up, but the lower sensitivity and specificity of CEA and CA15-3 limits them in the early diagnosis and other applications. This study analyzed the CEA and CA15-3 expressions in circulating in the Recurrence/metastatic Breast Cancer patients and compared the CEA and C15-3 levels in patients of breast cancer before and after the operation. It explored their clinical values in breast cancer follow-up monitoring. Hope that the study can provide a reference to clinical application. Methods: We selected 50 cases from the outpatients and the rehospitalization patients with recurrence/metastatic breast cancer randomly. They were all treated at Breast Center of The Fourth Hospital of Hebei Medical University from 2010-6 to 2011-3, including 34 cases of distant metastasis and 16 cases of local recurrence. We also selected 30 cases from the primary breast cancer patients hospitalized who had surgical operations. We use the electrochemiluminescence method to detect the serum CEA and CA15-3 levels in surgical patients before and after operation and in the recurrence/metastatic breast cancer patients, and then analyze with the SPSS 13.0 statistical software.Results:1 The comparison of the serum CEA and CA15-3 levels in breast cancer patients before and 1 month after operation. In this study, we studied 30 patients with primary breast cancer. The median of the serum CEA levels before surgery is 1.47ng/ml (0.2ng/ml ~ 4.87ng/ml), and it becomes 1.17ng/ml (0.49ng/ml ~ 3.31 ng/ml) 1 month after the operation. The difference between them has statistically significance (P=0.023). Before the operation, the median of serum CA15-3 levels is 11.4U/ml (5.62U/ml ~ 36.7U/ml), and 1 month after the operation the median is 13.2U/ml (6.06U/ml~51.36 U/ml). The difference between them has no statistically significance (P = 0.290).2 We studied the positive rates of 50 patients with recurrence/metastatic breast cancer. The positive rate of serum CEA is 40%. The positive rate of CA15-3 is 46%, and the positive rate of CEA and CA153 combined detection is 60%. The false negative rate is 35.8%. We analyzed them, and the result showed that the difference between the positive rate of serum CEA and the CA15-3 had no statistically significance(χ~2=0.367; P=0.545); the difference between the positive rate of CEA and CA153 combined detection and the positive of CEA had statistically significance(χ~2=4.000; P=0.046), but compared with the CA15-3, there was no statistically significance (χ~2=1.967; P=0.161). 3 According to the different parts in recurrence and metastasis, the recurrence/metastatic breast cancer patients were separated into two groups, local recurrence and distant metastasis group. Local recurrence group consisted of 16 cases and distant metastasis group included 34 cases. Each group respectively compared the positive rates of serum CEA and CA15-3. It was found that: in the distant metastasis group, the positive rate of CA15 -3(50%) was higher than CEA(47.1%). But the difference had no statistically significance (χ~2=0.582; P=0.704); in the local recurrence group, the positive rate of CA15-3 was 37.5% and the positive rate of CEA was 25%. The difference between them had no statistically significance(χ~2=0.059; P=1.000); the positive rate of CEA in distant metastasis group compared with the positive of the local recurrence group, there is no statistically significance (χ~2=2.206; P=0.546) between them; the positive rate of CA15-3 in distant metastasis group is also not higher than local recurrence group (χ~2= 0.684; P=0.216).Conclusion:1 In the patients with surgical treatment, the difference of CEA level between the before and 1 month after operation has statistical significance, while the difference of CA15-3 level showed no statistical significance. Tip: After the operation, the decrease of serum CA15-3 level is slower than the CEA. Then 1month after the operation, we can evaluate the efficacy of operation by the CEA detection, however, the change of CA15-3 is not so obvious.2 In recurrence/metastatic breast cancer patients,the positive rate of CEA is lower than that of CA15-3.But the difference has no statistical significance. The positive rate of the CEA and CA15-3 combined detection is higher than a single detection of CEA, and the difference has statistical significance. But compared with the CA15-3, the difference has no statistical significance. Tip: In recurrence/metastatic breast cancer patients, the combi- nation detection of CEA and CA15-3 shows higher value in the diagnosis of recurrence/metastatic breast cancer than a single detection of CEA, but compared with the single detection of serum CA15-3, there is no difference.3 Neither in local recurrence breast cancer patients nor in the distant metastasis patients, the positive rate of the CA15-3 has no difference from the CEA. Tip: In recurrence/metastatic breast cancer patients, the value of serum CA15-3 detection in diagnosis is not better than the CEA detection.4 In the distant metastasis patients, neither the positive rate of CEA nor the CA15-3 is different from the positive rate in the local recurrence patients. Tip: In recurrence/metastatic breast cancer patients, there was no statistical significance between the local recurrence and distant metastasis patients at the positive rates of the CEA or CA15-3.
|
PDF Full Text Request