Assessing Clinical Significance of Serum CA15-3 and Carcinoembryonic Antigen (CEA) Levels in Breast Cancer Patients: A Meta-Analysis

Fu, Yuhua; Li, Hui

doi:10.12659/msm.896563

Cited by 64 publications

(58 citation statements)

References 20 publications

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“…The results of our study indicated that abnormal high CA153 level significantly increased the risk of bone metastases in breast cancer. And the cut-off value of it was 23.25 U/ml in the present study, which was reported to be ranged from 22 to 60 u/ml in previous studies 17, 18 . In line with Wojtacki et al .…”

Section: Discussionsupporting

confidence: 58%

Clinical characteristics and risk factors for developing bone metastases in patients with breast cancer

Chen

Shen

Zhou

et al. 2017

Sci Rep

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The risk factors for predicting bone metastases in patients with breast cancer are still controversial. Here, a total of 2133 patients with breast cancer, including 327 with bone metastases (15.33%) and 1806 without bone metastases (84.67%) were retrospective reviewed from January 2005 to December 2015. The spine was found to be the most common site for bone metastases, followed by ribs (57.5%), pelvis (54.1%) and sternum (44.3%). The results indicated that axillary lymph node metastases and the concentrations of CA125, CA153, ALP and hemoglobin were the independent risk factors for bone metastases in patients with breast cancer. The receiver operating characteristics (ROC) curves showed that combined axillary lymph node metastases, high CA153 and ALP, with low hemoglobin were the most accurate biomarkers for predicting bone metastases in breast cancer [area under the curve = 0.900], and the sensitivity and specificity for the prediction were 78.5% and 87.8%, respectively. Therefore, breast cancer patients with more axillary lymph node metastases, high serum concentrations of CA125, CA153, ALP and low level of hemoglobin were closely related to bone metastases. Combined axillary lymph node metastases, CA153, ALP with hemoglobin have the highest predictive accuracy for bone metastases in breast cancer.

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Section: Discussionsupporting

confidence: 58%

Clinical characteristics and risk factors for developing bone metastases in patients with breast cancer

Chen

Shen

Zhou

et al. 2017

Sci Rep

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“…In our study, 100% of all eligible patients were monitored. Previous studies have profiled a small number of genes (i.e., [2][3][4][5][6][7][8][9][10][11][12][13][14] to determine the personalized variants for tracking; however, only 57% to 78% of women have any trackable mutations using such an approach (16,19,20). In our cohort, only 33 of 49 (67%) patients had one or more driver mutations identified in their exome profile, indicating that 16 of 49 patients in this study would not have been able to be monitored using a predetermined gene panel approach based on driver genes.…”

Section: Discussionmentioning

confidence: 99%

“…However, imaging tests such as mammography, MRI, and PET/CT often suffer from significant false-negative and false-positive results (8)(9)(10). Biochemical methodologies such as serum levels of cancer antigen 15-3 (CA 15-3) have limited sensitivity and accuracy in detecting micrometastases (11)(12)(13) and have not been widely incorporated into clinical guidelines (14). Therefore, there is a compelling need to develop more sensitive technologies capable of detecting preclinical metastases and identifying patients with disease recurrence earlier.…”

Section: Introductionmentioning

confidence: 99%

Personalized Detection of Circulating Tumor DNA Antedates Breast Cancer Metastatic Recurrence

Coombes

Page

Salari

et al. 2019

Clinical Cancer Research

331

297

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Purpose: Up to 30% of patients with breast cancer relapse after primary treatment. There are no sensitive and reliable tests to monitor these patients and detect distant metastases before overt recurrence. Here, we demonstrate the use of personalized circulating tumor DNA (ctDNA) profiling for detection of recurrence in breast cancer.Experimental Design: Forty-nine primary patients with breast cancer were recruited following surgery and adjuvant therapy. Plasma samples (n ¼ 208) were collected every 6 months for up to 4 years. Personalized assays targeting 16 variants selected from primary tumor whole-exome data were tested in serial plasma for the presence of ctDNA by ultradeep sequencing (average >100,000X).Results: Plasma ctDNA was detected ahead of clinical or radiologic relapse in 16 of the 18 relapsed patients (sensitivity of 89%); metastatic relapse was predicted with a lead time of up to 2 years (median, 8.9 months; range, 0.5-24.0 months). None of the 31 nonrelapsing patients were ctDNA-positive at any time point across 156 plasma samples (specificity of 100%). Of the two relapsed patients who were not detected in the study, the first had only a local recurrence, whereas the second patient had bone recurrence and had completed chemotherapy just 13 days prior to blood sampling.Conclusions: This study demonstrates that patientspecific ctDNA analysis can be a sensitive and specific approach for disease surveillance for patients with breast cancer. More importantly, earlier detection of up to 2 years provides a possible window for therapeutic intervention. Personalized profiling detects rising ctDNA ahead of clinical relapse. A-E, Plasma levels of ctDNA across serial plasma time points for five patients with breast cancer (one per panel). Mean VAFs are denoted by a dark blue circle, and solid lines represent the average VAF profile over time. The lead time is calculated as the time interval between clinical relapse (red triangle) and molecular relapse (blue triangle). CA 15-3 levels are graphed over time (teal circle), and the baseline levels (32 U/mL) are marked in light blue. F, Summary of percent VAF and number of targets detected at molecular and clinical relapse for all ctDNA-positive samples. Data are from 13 relapsed patients, excluding three patients with only one plasma time point. Coombes et al.

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“…In particular, changes in the blood composition are often observed starting from an early stage. Tumor markers are often correlated with progression and they have been reported to change following recurrence before other symptoms can be detected using different tests [6][7][8]. Carcinoembryonic antigen (CEA) and cancer antigen (CA15-3) are commonly used as tumor markers for breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Factors predictive of invasive ductal carcinoma in cases preoperatively diagnosed as ductal carcinoma in situ

Takada

Kashiwagi

Asano

et al. 2020

Preprint

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Background Invasion is often found in the postoperative pathological examination of cases diagnosed as ductal carcinoma in situ (DCIS) by histological examinations such as core needle biopsy (CNB) or vacuum-assisted biopsy (VAB). A meta-analysis reported that 25.9% of invasive ductal carcinoma (IDC) cases are diagnosed as DCIS preoperatively by CNB. Risk factors for invasion by postoperative examination have been studied, but no factors have been found that could be assessed preoperatively from blood tests. In this study, we investigated factors predictive of invasion based on preoperative blood tests in patients diagnosed with DCIS by preoperative biopsy. Methods In this study, 118 patients who were diagnosed with DCIS by preoperative biopsy were included. Biopsies were performed with 16-gauge CNB or VAB. Peripheral blood was obtained at the time of diagnosis. This study evaluated absolute platelet count, absolute lymphocyte count, lactate dehydrogenase, carcinoembryonic antigen, and cancer antigen 15-3 (CA15-3). The platelet–lymphocyte ratio (PLR) was calculated by dividing the absolute platelet count by the absolute lymphocyte count, and patients were grouped into high PLR (≥160.0) and low PLR (<160.0) groups. Results Invasion was found more frequently after surgery in pathologically high-grade cases than in pathologically not-high-grade cases (p = 0.015). The median PLR was 138.9, and 48 patients (40.7%) were classified into the high PLR group. The high PLR group was significantly more likely to have invasion in the postoperative pathology than the low PLR group (p = 0.018). In multivariate analysis of factors predictive of invasion in postoperative pathology, a high PLR (p = 0.007, odds ratio [OR] = 3.212), larger tumor size (p = 0.044, OR = 2.758), and biopsy method (VAB vs CNB, p = 0.001, OR = 0.206) were independent risk factors. Conclusions The PLR may be a predictor of invasion in the postoperative pathology for patients diagnosed with DCIS by preoperative biopsy.

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Assessing Clinical Significance of Serum CA15-3 and Carcinoembryonic Antigen (CEA) Levels in Breast Cancer Patients: A Meta-Analysis

Cited by 64 publications

References 20 publications

Clinical characteristics and risk factors for developing bone metastases in patients with breast cancer

Clinical characteristics and risk factors for developing bone metastases in patients with breast cancer

Personalized Detection of Circulating Tumor DNA Antedates Breast Cancer Metastatic Recurrence

Factors predictive of invasive ductal carcinoma in cases preoperatively diagnosed as ductal carcinoma in situ

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