Hayes D F, Zurawski V R, Kufe D W
J Clin Oncol. 1986 Oct;4(10):1542-50. doi: 10.1200/JCO.1986.4.10.1542.
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 greater than 22 U/mL, while that from 58 (5.5%) and 14 (1.3%) had levels greater than 25 U/mL and 30 U/mL, respectively. In contrast, 115 of 158 patients (73%) with metastatic breast cancer had CA15-3 levels greater than 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 greater than 22 U/mL. Furthermore, nine of 31 patients (29%) with primary breast cancer had CA15-3 levels greater than 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 less than .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 less than .02). CA15-3 levels were greater than 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 greater than 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.
一种免疫放射分析（IRMA）已被用于测定乳腺癌相关抗原CA15 - 3的循环水平。在1050名正常对照受试者中，99名（9.4%）的血清CA15 - 3抗原水平大于22 U/mL，而58名（5.5%）和14名（1.3%）的血清CA15 - 3水平分别大于25 U/mL和30 U/mL。相比之下，158例转移性乳腺癌患者中有115例（73%）的CA15 - 3水平大于22 U/mL。26例仅发生局部转移的患者中有13例（50%）、34例仅发生骨转移的患者中有27例（79%）以及24例发生肝转移的患者中有20例（83%）的CA15 - 3水平大于22 U/mL。此外，31例原发性乳腺癌患者中有9例（29%）的CA15 - 3水平大于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水平升高的患者明显多于CEA水平升高的患者（P小于0.001）。此外，CA15 - 3免疫放射分析在仅发生骨转移以及仅发生局部转移的患者中比CEA检测更敏感。原发性乳腺癌患者中CA15 - 3水平升高的患者也明显多于CEA水平升高的患者（P小于0.02）。在患有非恶性疾病的患者中，CA15 - 3水平大于22 U/mL，包括25例良性乳腺疾病患者中的5例（20%）以及52例良性肝病患者中的23例（44%）。此外，54例胃肠道（GI）恶性肿瘤患者中有24例（44%）、17例支气管源性癌患者中有12例（71%）以及44例上皮性卵巢癌患者中有29例（66%）的CA15 - 3水平也大于22 U/mL。连续的CA15 - 3水平与临床病程相关。21例肿瘤进展患者中有19例（91%）的CA15 - 3水平至少升高了25%。相反，9例肿瘤消退患者中有7例（78%）的CA15 - 3水平至少降低了50%。在27例病情稳定的患者中，16例（59%）的CA15 - 3水平变化不超过原始水平的±25%。这些结果表明，CA15 - 3抗原是评估和监测乳腺癌患者的敏感标志物。
