Colomer R, Ruibal A, Genollà J, Salvador L
Medical Oncology Unit, Valle de Hebrón Hospital, Barcelona, Spain.
Br J Cancer. 1989 Feb;59(2):283-6. doi: 10.1038/bjc.1989.58.
Abnormal CA 15-3 antigen levels are found in the serum of most patients with advanced breast carcinoma. Elevations of this marker are less frequently seen in other malignancies. Circulating CA 15-3 levels might be useful in the differential diagnosis of the primary site of cancer. We studied the levels of CA 15-3 in 500 patients with different non-mammary cancers. Elevations of CA 15-3 (greater than 40 U ml-1) were observed in all types of epithelial malignancies, especially in ovarian (46%), respiratory (26%) and liver (30%) carcinomas. Abnormal values were observed in some patients with haematological malignancies and sarcomas, but not in melanoma or neurological tumours. CA 15-3 antigen levels correlated with the extent of non-mammary malignant tumours. Patients with locoregional cancer had a significantly smaller proportion of elevations of the antigen than those with distant metastases (12% versus 35%, P less than 0.001). In particular, elevated CA 15-3 levels were observed in 70% of patients with metastatic ovarian cancer. Liver involvement by cancer did not produce more elevations of CA 15-3 than metastases to other organs (32% versus 39%). Simultaneous determination of circulating CA 15-3 and CA 125 antigens in 58 patients with cancer of the ovary showed that CA 15-3 is elevated in some cases of ovarian carcinoma with non-elevated CA 125, and that CA 15-3 and CA 125 are distinct antigens. We conclude that circulating CA 15-3 antigen levels can be found elevated in virtually all types of cancer, particularly when distant metastases are present. Therefore, CA 15-3 levels should not be used in the differential diagnosis of the primary site in patients with metastatic malignancies of unknown origin. Evaluation of CA 15-3 levels may enhance the sensitivity of CA 125 in monitoring the course of ovarian carcinoma.
大多数晚期乳腺癌患者的血清中可检测到异常的CA 15-3抗原水平。在其他恶性肿瘤中较少见该标志物升高。循环CA 15-3水平可能有助于癌症原发部位的鉴别诊断。我们研究了500例不同类型非乳腺癌患者的CA 15-3水平。在所有类型的上皮性恶性肿瘤中均观察到CA 15-3升高（大于40 U/ml），尤其是卵巢癌（46%）、呼吸道癌（26%）和肝癌（30%）。在一些血液系统恶性肿瘤和肉瘤患者中也观察到异常值，但黑色素瘤或神经肿瘤患者未出现异常。CA 15-3抗原水平与非乳腺恶性肿瘤的范围相关。局部癌症患者抗原升高的比例明显低于远处转移患者（12%对35%，P<0.001）。特别是，70%的转移性卵巢癌患者CA 15-3水平升高。癌症累及肝脏与转移至其他器官相比，CA 15-3升高的情况并无更多差异（32%对39%）。对58例卵巢癌患者同时检测循环CA 15-3和CA 125抗原，结果显示在一些CA 125未升高的卵巢癌病例中CA 15-3升高，且CA 15-3和CA 125是不同的抗原。我们得出结论，实际上在所有类型的癌症中均可发现循环CA 15-3抗原水平升高，尤其是存在远处转移时。因此，CA 15-3水平不应用于不明原发部位转移性恶性肿瘤患者的原发部位鉴别诊断。评估CA 15-3水平可能会提高CA 125监测卵巢癌病程的敏感性。
