Nicolini Andrea, Carpi Angelo, Ferrari Paola, Morganti Riccardo, Mazzotti Valentina, Barak Vivian, Duffy Michael J
Department of Oncology, Transplantations and New Technologies in Medicine, University of Pisa, Pisa, Italy,
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Cancer Manag Res. 2018 Dec 13;10:6879-6886. doi: 10.2147/CMAR.S177522. eCollection 2018.
The purpose of this study was to evaluate the combined measurement of serum CEA, TPA, and CA 15-3, using an individual reference limit (IRL), for predicting distant metastases in asymptomatic women following a diagnosis of primary breast cancer.
A total of 231 patients were followed up for a mean of 5.5±1.6 years. An IRL for defining critical changes (CCs) in marker levels was used as a warning signal of pending distant metastases.
Sensitivity, specificity, and accuracy of the combined CEA-TPA-CA 15-3 marker panel for predicting patient outcome were 95.2%, 97.8%, and 97.9%, respectively. In all, 19 (8.3%) patients relapsed with a mean lead time to radiological evidence of metastases of 11.7±13.8 months.
We concluded that the combined measurement of CA 15-3, CEA, and TPA using an IRL for determining the CC in markers levels is an accurate strategy for predicting outcome during postoperative monitoring of asymptomatic breast cancer patients. Whether the early prediction of metastasis and subsequent administration of therapy impacts on patient outcome should now be the objective of a prospective clinical trial. The marker panel described here could serve as the basis for such a trial.
本研究旨在评估采用个体参考限值（IRL）联合检测血清癌胚抗原（CEA）、组织多肽抗原（TPA）和糖类抗原15-3（CA 15-3），以预测原发性乳腺癌诊断后无症状女性发生远处转移的情况。
共对231例患者进行了平均5.5±1.6年的随访。使用定义标志物水平临界变化（CCs）的IRL作为即将发生远处转移的警示信号。
联合CEA-TPA-CA 15-3标志物组预测患者预后的敏感性、特异性和准确性分别为95.2%、97.8%和97.9%。共有19例（8.3%）患者复发，出现转移的影像学证据的平均提前期为11.7±13.8个月。
我们得出结论，采用IRL联合检测CA 15-3、CEA和TPA以确定标志物水平的CCs，是预测无症状乳腺癌患者术后监测期间预后的准确策略。转移的早期预测及后续治疗的实施是否会影响患者预后，现在应成为一项前瞻性临床试验的目标。本文所述的标志物组可作为此类试验的基础。
