Department of Medical Oncology, British Columbia Cancer Agency, Vancouver Cancer Center, Vancouver, Canada.
Ann Oncol. 2012 Feb;23(2):338-45. doi: 10.1093/annonc/mdr154. Epub 2011 May 4.
Little is known about the correlations between tumor markers (TMs), breast cancer subtypes, site(s) of metastasis and prognosis.
Women diagnosed with metastatic breast cancer were included. Breast cancer subtypes were defined as LuminalA, LuminalB, LuminalHer2, Her2, Basal and non-Basal triple negative (TN). Levels of elevation of TM values [cancer antigen 15-3 (CA 15-3), carcinoembryonic antigen (CEA) and cancer antigen 125 (CA 125)] among the subtypes were analyzed. Site(s) of metastasis and outcomes were captured.
Eight hundred and ten patients were included. Luminal subtypes were associated with an elevation in at least one TM: 90.8% of LuminalHer2+, 90% of LuminalB and 88.6% of LuminalA. TMs were less frequently elevated in Basal (74.1%) and non-Basal TN (71.4%) cases (P < 0.001). CA 15-3 was the most frequently elevated TM. The incidence of TM elevation did not differ between patients with solitary versus multiple metastatic sites. Breast cancer-specific survival (BCSS) was significantly worse for patients with elevated TMs (P = 0.001).
TM elevation of CA 15-3, CEA and/or CA 125 was documented in the majority of patients with metastatic breast cancer with CA 15-3 occurring most commonly. Luminal subtypes expressed elevated TMs significantly more frequently compared with the non-Luminal groups. TM elevation was not different between the different sites of metastasis. Overall, elevated TMs predicted a worse BCSS.
关于肿瘤标志物（TMs）、乳腺癌亚型、转移部位和预后之间的相关性知之甚少。
纳入诊断为转移性乳腺癌的女性患者。乳腺癌亚型定义为 LuminalA、LuminalB、LuminalHer2、Her2、基底和非基底三阴性（TN）。分析了各亚型 TMs 值升高的情况[癌抗原 15-3（CA 15-3）、癌胚抗原（CEA）和癌抗原 125（CA 125）]。记录转移部位和结局。
共纳入 810 例患者。Luminal 亚型与至少一种 TM 升高相关：LuminalHer2+ 为 90.8%、LuminalB 为 90%、LuminalA 为 88.6%。基底型（74.1%）和非基底型 TN（71.4%）病例中 TMs 升高的频率较低（P<0.001）。CA 15-3 是最常升高的 TM。有单一或多个转移部位的患者 TM 升高的发生率无差异。TM 升高的患者乳腺癌特异性生存率（BCSS）显著更差（P=0.001）。
大多数转移性乳腺癌患者的 CA 15-3、CEA 和/或 CA 125 升高，最常见的是 CA 15-3。与非 Luminal 组相比，Luminal 亚型表达 TMs 升高的频率显著更高。不同转移部位的 TM 升高无差异。总体而言，TM 升高预示着 BCSS 更差。
