Department of Obstetrics and Gynecology, Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
Cancer Epidemiol Biomarkers Prev. 2024 Sep 3;33(9):1211-1219. doi: 10.1158/1055-9965.EPI-24-0187.
Cancers of ductal origin often express glycoprotein mucin 1 (MUC1), also known as CA15.3, with higher levels leading to poor prognosis. Conversely, anti-MUC1 antibodies develop in some patients, leading to better prognosis. We sought to identify epidemiologic factors associated with CA15.3 antigen or antibody levels.
Levels of CA15.3 antigen and anti-CA15.3 IgG antibodies were measured in archived sera from 2,302 mostly healthy women from the National Health and Nutritional Survey; and epidemiologic predictors of their levels were examined using multivariate and correlational analyses.
Among racial groups, Black women had the highest levels of CA15.3 antigen and lowest levels of antibodies. Increasing body mass index and current smoking were associated with low anti-CA15.3 antibody levels. Low CA15.3 antigen levels were seen in oral contraceptive users and high levels in women who were pregnant or lactating at the time of blood collection, with the latter group also having high antibody levels. Past reproductive events associated with high antigen levels included the following: later age at menarche, having given birth, and history of endometriosis. Lower antigen levels were seen with increasing duration of OC use. Anti-CA15.3 antibody levels decreased with an increasing estimated number of ovulatory years.
Key determinants of CA.15.3 antigen or antibody levels include the following: race, body mass index, smoking, later menarche, childbirth, number of ovulatory cycles, and endometriosis.
This study supports the premise that known epidemiologic factors affecting risk for or survival after MUC1-expressing cancers may, at least partially, operate through their association with CA15.3 antigen or antibody levels.
导管来源的癌症通常表达糖蛋白黏蛋白 1（MUC1），也称为 CA15.3，其水平较高预示着预后不良。相反，一些患者会产生抗 MUC1 抗体，从而导致预后更好。我们试图确定与 CA15.3 抗原或抗体水平相关的流行病学因素。
我们测量了来自国家健康和营养调查的 2302 名主要健康女性的存档血清中的 CA15.3 抗原和抗 CA15.3 IgG 抗体水平；并使用多元和相关分析来检查其水平的流行病学预测因素。
在不同种族群体中，黑人女性的 CA15.3 抗原水平最高，抗体水平最低。体重指数增加和当前吸烟与低抗 CA15.3 抗体水平相关。口服避孕药使用者的 CA15.3 抗原水平较低，处于妊娠或哺乳期的女性水平较高，后者的抗体水平也较高。与抗原水平升高相关的过去生殖事件包括：初潮年龄较晚、分娩和子宫内膜异位症病史。口服避孕药使用时间越长，抗原水平越低。抗 CA15.3 抗体水平随估计排卵年数的增加而降低。
CA15.3 抗原或抗体水平的关键决定因素包括：种族、体重指数、吸烟、初潮年龄较晚、分娩、排卵周期数和子宫内膜异位症。
本研究支持这样一个前提，即影响 MUC1 表达型癌症风险或生存的已知流行病学因素可能至少部分通过其与 CA15.3 抗原或抗体水平的关联起作用。
