Evaluation of CEA, TPA, CA 15-3, CA 549 and TPS in the monitoring of metastatic breast cancer.

Monitoring the response to treatment in relapsed breast cancer patients is one of the chief uses of tumor markers. Thus far the carcinoembryonic antigen (CEA)-tissue polypeptide antigen (TPA)-breast cancer associated antigen 115 D8/DF3 (CA 15-3) association has been routinely used to follow-up breast cancer patients. We have found that TPA reflects the response to treatment much better than CEA and slightly better than CA 15-3. Recently carcinoma associated antigen 549 (CA 549) and tissue polypeptide specific antigen (TPS) have been reported to be highly sensitive tumor markers for breast cancer. TPS is claimed to be particularly suitable for monitoring the response to treatment because of its more specific assessment of proliferation activity. Therefore, in 13 relapsed patients with prolonged follow-up and detailed clinical-instrumental information, the mean percentage of samples with high CEA, TPA, and CA 15-3 values and their expressions were compared with those of CA 549 and TPS. All markers were also evaluated in terms of their correspondence with the evolution of disease. The correspondence with clinical-instrumental behaviour was scored absent (0), poor (1), good (2) and very good (3) by three different observers. Other more suitable associations than those already used were also investigated. It was found that CA 15-3 and CA 549 were expressed more often (92%) than TPS (85%), TPA (60%) and CEA (46%).(ABSTRACT TRUNCATED AT 250 WORDS)