Elfagieh Mohamed, Abdalla Fathi, Gliwan Asma, Boder Jamela, Nichols Wafa, Buhmeida Abdelbaset
Department of Surgical Oncology, National Cancer Institute, Misurata, Libya.
Tumour Biol. 2012 Dec;33(6):2371-7. doi: 10.1007/s13277-012-0500-6. Epub 2012 Sep 5.
Results from studies on efficacy of carcinoembryonic antigen (CEA), carbohydrate antigen 15.3 (CA 15.3) and thymidine kinase (TK1) as diagnostic and prognostic tools for primary breast cancer (BC) have presented conflicting results, and usefulness of these markers for clinical use in BC remains unclear. The aim of this study is to evaluate potential of concentration of the sera CEA, CA15.3 and TK1 peptides' use as markers in the diagnosis and prognosis of breast lesions of Libyan patients. Serum tumour markers were studied in 20 healthy subjects, 30 patient with benign lesion diseases and 50 patients with histologically confirmed BC diagnosed at the National Cancer Institute (NCI), Misurata, Libya during the period 2005-2009. The concentrations of the BC patients' cutoff points used for diagnostic and prognostic sensitivity were 8.82 ng/ml, 35.57 U/ml and 32.57 U/mg/protein for CEA, CA15.3 and TK1, respectively. Increased CEA (>8.82 ng/ml), CA 15.3 (>35.57 U/ml) and TK1 (>32.57 U/mg/protein) concentrations were found in 62 %, 70 % and 78 % of the BC patients, respectively. For all three tumour markers, increased concentrations correlated increased tumour size and nodal involvement. Significantly higher serum TK1 levels were found in patients with advanced disease (p < 0.0001) and TK1 levels also correlated with disease-specific survival (DSS, p < 0.07). The combined data set of the three markers' data from three markers increased the diagnostic sensitivity to 90 %. The serum marker analysis for CEA, CA 15.3, and S-TK1 concentrations is shown to be a useful tool for identification of malignant cases in our BC population and for the prognostic evaluation of patients with primary BC. Increased concentrations of the markers were also observed to be higher in patients with advanced tumours and indicative of the development of distant metastasis.
关于癌胚抗原(CEA)、糖类抗原15.3(CA 15.3)和胸苷激酶(TK1)作为原发性乳腺癌(BC)诊断和预后工具的疗效研究结果相互矛盾,这些标志物在BC临床应用中的实用性仍不明确。本研究的目的是评估血清CEA、CA15.3和TK1肽浓度作为利比亚患者乳腺病变诊断和预后标志物的潜力。在2005年至2009年期间,对利比亚米苏拉塔国家癌症研究所(NCI)诊断的20名健康受试者、30名患有良性病变疾病的患者和50名经组织学确诊为BC的患者进行了血清肿瘤标志物研究。用于诊断和预后敏感性的BC患者截断点浓度,CEA、CA15.3和TK1分别为8.82 ng/ml、35.57 U/ml和32.57 U/mg/蛋白质。分别在62%、70%和78%的BC患者中发现CEA(>8.82 ng/ml)、CA 15.3(>35.57 U/ml)和TK1(>32.57 U/mg/蛋白质)浓度升高。对于所有三种肿瘤标志物,浓度升高与肿瘤大小增加和淋巴结受累相关。晚期疾病患者的血清TK1水平显著更高(p < 0.0001),并且TK1水平也与疾病特异性生存(DSS,p < 0.07)相关。来自三种标志物的三种标志物数据集组合将诊断敏感性提高到90%。CEA、CA 15.3和S-TK1浓度的血清标志物分析被证明是识别我们BC人群中恶性病例以及对原发性BC患者进行预后评估的有用工具。在晚期肿瘤患者中也观察到标志物浓度升高,并且表明远处转移的发生。