Comparison of Tissue Polypeptide Antigen (TPA) with Cancer Antigen 15-3 (CA 15-3) and Carcino-embryonic Antigen (CEA) in Follow-up of Breast Cancer

Abstract

Cancer antigen 15-3 (CA 15-3), carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) were measured in 679 sera of breast cancer patients and in 94 sera of women without breast cancer. The tumour markers were determined using immunoluminometric assays (ILMA). The assays are characterised by an inter-assay-imprecision and intra-assay-imprecision <4 %. The breast cancer patients were staged according to the TNM classification stage 0-IV (by UICC) in patient groups with a compatible prognosis. Median and range of each stage were investigated. The cut-off values (95th and 97.5th percentile of control group) of CA 15-3, CEA and TPA were determined; specificity, sensitivity, positive and negative predictive value (PV) and efficiency were investigated for these cut-off's and the receiver operating characteristic (ROC) curves were calculated. The differences between control group and stage 0-3 were shown as non-significant for CA 15-3 and CEA but significant for TPA. Significant differences were found in stage 4 for all three tumour markers. The three tumour markers did not have differences in specificity, positive and negative PV and efficiency. TPA and CA 15-3 demonstrated comparable results in sensitivity and ROC curve analyses. These results were better than those from CEA.

EMA: A Differentiation Antigen Related to Node Metastatic Capacity of Breast Carcinomas

“…Its metabolism is regulated by steroid hormones, and its production increases during lactation [24,32]. EMA is also upregulated in carcinogenesis, and its serum levels, when high, are indicators of poor prognosis for breast cancer patients [1,12,18,25,31]. The almost constant presence of EMA in breast cancer cells facilitates the detection of micrometastases in lymph nodes and bone marrow.…”

“…Only cells with a moderate to strong staining in character were counted; thus, intensity, when low, even though diffuse, was considered negative. Initially, eight patterns were distinguished: lineal tubular (24), lineal peripheral (12), lineal disordered (17), pure cytoplasmic (208), cytoplasmic mixed with internal (25), external (8) or irregular lineal (7) and negative (29). These patterns were then ordered into three groups: lineal (lineal 2 or 3 and cytoplasmic 1), cytoplasmic (cytoplasmic 2 or 3 and any kind of lineal), and negative (lineal or cytoplasmic 1).…”

Translational pathology of neoplasia

“… * Tissue polypeptide antigen (TPA) is a heterogenous combination of cytokeratins 8, 18, and 19 that can be measured in serum or urine; TPA has been considered as markers of cellular proliferation or apoptosis and hence maybe increased in patients with tumors [40,41]. …”