Anoop Thattungal Manoharan, Joseph P Rona, Soman Saikumar, Chacko Steffi, Mathew Mintu
Department of Medical Oncology, Regional Cancer Center, Trivandrum 695011, Kerala, India.
World J Clin Oncol. 2022 Jun 24;13(6):529-539. doi: 10.5306/wjco.v13.i6.529.
Carcinoembryonic antigen (CEA) is an important serum tumour marker with a substantial role in diagnosis and monitoring of various solid tumours. About 36%-70% of breast cancers have elevated serum CEA. And the available studies show discrepancy in addressing the prognostic significance of CEA in advanced breast cancer.
To estimate the serum CEA level in our metastatic breast cancer patients and correlate it with response to treatment and clinical outcome.
This was a prospective clinical study conducted on 50 metastatic breast cancer patients treated at breast clinic, with newly diagnosed metastatic breast cancer planned for palliative chemotherapy, targeted therapy, and hormonal treatment. We estimated the proportion of patients with elevated serum CEA level at baseline and after palliative treatment and also studied the association of serum CEA levels with known prognostic factors. The response to treatment was correlated with the serum CEA levels in the context of responders and non-responders.
The median pre-treatment and post-treatment CEA levels were 7.9 (1.8-40.7) ng/mL and 4.39 (1.4-12.15) ng/mL, respectively, in the whole study population ( = 0.032). No statistically significant difference was seen in baseline serum CEA between responders and non-responders. Even in the luminal group, pre-treatment serum CEA was not a predictor of response, but post-treatment CEA was a significant predictor of tumour progression. In patients with liver and lung metastases, post-treatment CEA level difference was not statistically significant in both responders and non-responders though the values were higher in non-responders. Among those with bone metastases, 69.5% had elevated post-treatment serum CEA, and only 37.5% had elevated serum CEA in those with no bone metastases.
Elevated post-treatment serum CEA levels are associated with disease progression and poor response to therapy. Persistently elevated post-treatment serum CEA levels are significantly associated with bone metastases. Elevated serum CEA and hormonal status are significant predictors of treatment response.
癌胚抗原（CEA）是一种重要的血清肿瘤标志物，在各种实体瘤的诊断和监测中发挥着重要作用。约36%-70%的乳腺癌患者血清CEA升高。现有研究在探讨CEA在晚期乳腺癌中的预后意义方面存在差异。
评估我们的转移性乳腺癌患者的血清CEA水平，并将其与治疗反应和临床结局相关联。
这是一项前瞻性临床研究，对在乳腺诊所接受治疗的50例转移性乳腺癌患者进行，这些患者新诊断为转移性乳腺癌，计划接受姑息化疗、靶向治疗和激素治疗。我们估计了基线时和姑息治疗后血清CEA水平升高的患者比例，并研究了血清CEA水平与已知预后因素的关联。在有反应者和无反应者的背景下，将治疗反应与血清CEA水平相关联。
在整个研究人群中，治疗前和治疗后CEA水平的中位数分别为7.9（1.8-40.7）ng/mL和4.39（1.4-12.15）ng/mL（P = 0.032）。有反应者和无反应者的基线血清CEA无统计学显著差异。即使在管腔型组中，治疗前血清CEA也不是反应的预测指标，但治疗后CEA是肿瘤进展的显著预测指标。在有肝转移和肺转移的患者中，尽管无反应者的数值较高，但有反应者和无反应者治疗后CEA水平差异均无统计学意义。在有骨转移的患者中，69.5%的患者治疗后血清CEA升高，而在无骨转移的患者中只有37.5%的患者血清CEA升高。
治疗后血清CEA水平升高与疾病进展和治疗反应不佳相关。治疗后血清CEA水平持续升高与骨转移显著相关。血清CEA升高和激素状态是治疗反应的重要预测指标。
