Mudduwa Lakmini Kb, Wijayaratne Gaya B, Peiris Harshini H, Gunasekera Shania N, Abeysiriwardhana Deepthika, Liyanage Nimsha
Department of Pathology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka,
Department of Microbiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
Int J Womens Health. 2018 Jun 26;10:329-335. doi: 10.2147/IJWH.S162867. eCollection 2018.
CA15-3 is the most commonly used tumor marker in breast cancer. Its prognostic role has been described in the metastatic setting, but the role of pre-surgical CA15-3 in the assessment of patients with breast cancer without metastasis has not been substantiated yet.
From February 2014 for a 2-year period, this prospective study included all patients who were diagnosed with primary breast cancer and underwent surgery at a tertiary care hospital. The serum level of CA15-3 was assessed on a pre-surgical blood sample and later at the 3-, 6-, 9-, and 12-month follow-up by enzyme-linked immunosorbent assay. Disease-free survival (DFS) was analyzed with a Kaplan-Meier model and log-rank test.
We enrolled 195 patients (mean age ± SD 57.84 years ±13.819, range, 28-95) with breast cancer. The prevalence of elevated (≥30 U/mL) pre-surgical CA15-3 was 35.9%, and it reduced to 14.3% at 3 months after mastectomy. Pre-surgical CA15-3 had a significant association only with the size of the tumor (=0.047). Patients who did not have elevated pre-surgical CA15-3 (≥30 U/mL) had the best short-term DFS, and it was worst when the pre-surgical CA15-3 was >100 U/mL (=0.041).
Elevated pre-surgical CA15-3 is a predictor of poor short-term DFS of patients with breast cancer without distant metastasis.
CA15 - 3是乳腺癌中最常用的肿瘤标志物。其在转移情况下的预后作用已有描述，但术前CA15 - 3在评估无转移乳腺癌患者中的作用尚未得到证实。
从2014年2月起为期2年，这项前瞻性研究纳入了所有在三级护理医院被诊断为原发性乳腺癌并接受手术的患者。术前采集血样检测CA15 - 3血清水平，随后在3、6、9和12个月随访时通过酶联免疫吸附测定法进行检测。采用Kaplan - Meier模型和对数秩检验分析无病生存期（DFS）。
我们纳入了195例乳腺癌患者（平均年龄±标准差57.84岁±13.819，范围28 - 95岁）。术前CA15 - 3升高（≥30 U/mL）的患病率为35.9%，乳房切除术后3个月降至14.3%。术前CA15 - 3仅与肿瘤大小有显著关联（P = 0.047）。术前CA15 - 3未升高（≥30 U/mL）的患者短期DFS最佳，术前CA15 - 3>100 U/mL时最差（P = 0.041）。
术前CA15 - 3升高是无远处转移乳腺癌患者短期DFS不良的预测指标。
