Department of Clinical Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, PR China.
Department of Clinical Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, PR China.
Clin Chim Acta. 2021 Dec;523:19-25. doi: 10.1016/j.cca.2021.08.027. Epub 2021 Aug 26.
To explore the application value of breast cancer tumor markers tissue polypeptide specific antigen (TPS), carbohydrate antigen 15-3 (CA15-3), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) detection alone or in combination for the monitoring of distant metastasis of breast cancer.
The clinical data of 389 female breast cancer patients admitted to Tianjin Medical University Cancer Institute and Hospital from January 2016 to March 2017 were retrospectively analyzed. Serum levels of TPS, CA125, CA15-3, and CEA were compared to analyze their significance in prediction distant metastasis of breast cancer. The patients were divided into the distant metastatic group and the non-metastatic group according to whether the patients had distant metastasis. The non-metastatic group was divided into the control group and the occult metastasis group according to whether distant metastases occurred in 3 years after treatment.
The receiver operating characteristic curve analysis revealed that all four markers had the diagnostic value in distant metastasis of breast cancer (AUC = 0.754, AUC = 0.821, AUC = 0.755, AUC = 0.651) and in occult metastasis in 3 years after treatment (AUC = 0.751, AUC = 0.744, AUC = 0.725, AUC = 0.661). To estimate whether the discrimination ability could be improved by marker panels, we established marker panels composed of TPS, CA125, CA15-3, and CEA. To discriminate distant metastasis from non-distant metastasis, the diagnostic ability of different panels composed of TPS, CA125, CA15-3 and CEA did not show significant difference compared with single CA15-3 (P > 0.05). To discriminate occult metastasis from the control group, no significant difference was shown in AUC between marker panels and single marker (P > 0.05). However, the sensitivity was improved when the marker-panels were used overall.
All tumor markers have abilities in prediction of distant metastasis of breast cancer. The combined detection of the markers is more valuable than using single tumor marker in improving sensitivity. Two markers' panels are more suitable for the prediction of distant metastasis of breast cancer than three or four makers' panels with the similar sensitivity and AUC.
探讨乳腺癌肿瘤标志物组织多肽特异性抗原（TPS）、糖链抗原 15-3（CA15-3）、癌胚抗原（CEA）、糖链抗原 125（CA125）单项及联合检测对乳腺癌远处转移的监测价值。
回顾性分析 2016 年 1 月至 2017 年 3 月天津医科大学肿瘤医院收治的 389 例女性乳腺癌患者的临床资料，比较血清 TPS、CA125、CA15-3、CEA 水平在预测乳腺癌远处转移中的意义。根据患者是否发生远处转移将其分为远处转移组和无远处转移组，根据治疗后 3 年内是否发生远处转移将无远处转移组分为对照组和隐匿性远处转移组。
受试者工作特征曲线分析显示，4 项标志物对乳腺癌远处转移均具有诊断价值（AUC=0.754、AUC=0.821、AUC=0.755、AUC=0.651），对治疗后 3 年内隐匿性远处转移也具有诊断价值（AUC=0.751、AUC=0.744、AUC=0.725、AUC=0.661）。为评估标志物联合能否提高诊断效能，构建了 TPS、CA125、CA15-3、CEA 联合组成的标志物组合。为鉴别有无远处转移，联合检测 TPS、CA125、CA15-3、CEA 与单项 CA15-3 比较，诊断效能差异无统计学意义（P>0.05）。为鉴别隐匿性远处转移与对照组，联合检测 TPS、CA125、CA15-3、CEA 与单项标志物比较，AUC 差异无统计学意义（P>0.05），但敏感性提高。
乳腺癌患者的各肿瘤标志物均具有预测远处转移的能力，联合检测较单项肿瘤标志物更能提高诊断的敏感性。两项标志物联合组成的标志物组合更适合用于预测乳腺癌的远处转移，其诊断效能与敏感性、AUC 相似。
