University of Health Sciences, Tepecik Training and Research Hospital, Department of Medical Biochemistry, Izmir, Turkey.
Int J Vitam Nutr Res. 2019 Nov;89(5-6):255-260. doi: 10.1024/0300-9831/a000555. Epub 2019 Mar 11.
CA 15-3 is a tumor-associated antigen and is overexpressed in breast tumors, and may also be high in some other non-cancerous conditions. The aim of this study was to investigate the effect of megaloblastic anemia due to vitamin B12 or folic acid deficiency on the levels of tumor markers. Five-year patient data were retrospectively analyzed. The associations between megaloblastic anemia due to vitamin B12 deficiency and CA 15-3, CA 125, CA 19-9, CEA, and AFP levels were analyzed. Furthermore, association between CA 15-3 level and megaloblastic anemia due to folic acid deficiency was evaluated. Median CA 15-3 level was 38.1 U/mL in the group with megaloblastic anemia due to vitamin B12 deficiency(n = 15), 46.7 U/mL in the group with megaloblastic anemia related to folic acid deficiency (n = 3), and 17.8 U/mL in the normal group(n = 1724). CA 15-3 levels were significantly higher among patients with vitamin B12- and folic acid-associated megaloblastic anemia compared to the normal group (p = 0.001 and p = 0.005, respectively). Megaloblastic anemia due to vitamin B12 deficiency was not associated with any significant differences in CA 125, CA 19-9, CEA, or AFP levels compared to the normal group (p = 0.777, p = 0.327, p = 0.577, and p = 0.197, respectively). The numbers of anemic and normal subjects compared in these tests were 12 vs. 1501, 17 vs. 1827, 4 vs. 897, and 8 vs. 1041, respectively. In conclusion, megaloblastic anemia results in ineffective erythropoiesis, and increased levels of CA 15-3 may be associated with this issue. Clinicians should take this into account when evaluating for a pre-diagnosis of breast cancer.
CA 15-3 是一种肿瘤相关抗原，在乳腺癌中过度表达，也可能在某些非癌性疾病中升高。本研究旨在探讨巨幼细胞性贫血（由于维生素 B12 或叶酸缺乏引起）对肿瘤标志物水平的影响。回顾性分析了 5 年的患者数据。分析了维生素 B12 缺乏引起的巨幼细胞性贫血与 CA 15-3、CA 125、CA 19-9、CEA 和 AFP 水平之间的关系。此外，还评估了 CA 15-3 水平与叶酸缺乏引起的巨幼细胞性贫血之间的关系。维生素 B12 缺乏引起的巨幼细胞性贫血组(n=15)的中位 CA 15-3 水平为 38.1 U/mL，叶酸缺乏引起的巨幼细胞性贫血组(n=3)的中位 CA 15-3 水平为 46.7 U/mL，正常组(n=1724)的中位 CA 15-3 水平为 17.8 U/mL。与正常组相比，维生素 B12 和叶酸相关的巨幼细胞性贫血患者的 CA 15-3 水平显著升高(p=0.001 和 p=0.005)。与正常组相比，维生素 B12 缺乏引起的巨幼细胞性贫血与 CA 125、CA 19-9、CEA 或 AFP 水平无显著差异(p=0.777、p=0.327、p=0.577 和 p=0.197)。在这些测试中，贫血和正常受试者的数量分别为 12 对 1501、17 对 1827、4 对 897 和 8 对 1041。总之，巨幼细胞性贫血导致无效造血，CA 15-3 水平升高可能与此问题有关。临床医生在评估乳腺癌的诊断前应考虑到这一点。
