Correlation of Preoperative Serum Tumor Markers with Clinicopathological Features and Prognosis in Breast Cancer

Abstract

Background: Serologic tumor markers such as CA15-3, CEA and TPS have been used for decades to manage patients with breast cancer. Despite the frequent use of these markers, the prognostic significance of these markers remains indeterminate. Patients and methods: We retrospectively analyzed and followed up a set of 361 patients with Stages I~III breast cancer, from January 2001 to February 2011. Serumal CA15-3 and CEA levels were measured by electrochemistry (ELC), and serumal TPS was analyzed by enzyme-linked immunosorbent assays (ELISA). We explored the relationship between preoperative serologic tumor markers and clinicopathological parameters, the correlation between CA15-3, CEA or TPS levels with overall survival, and their impact on prognosis. Results: First, at the univariate analysis, higher preoperative serum CA15-3 was significantly associated with older age of onset (≥45 years, P=0.049), and the expression of TPS was related with some traditional prognostic factors such as tumor size (P=0.030), histologic grade (P=0.001) and lymph node status (P=0.008). Second, overall survival were significantly shorter among patients with elevated preoperative serum CA15-3 (P=0.000) or TPS (P=0.038) respectively. Finally, multivariate Cox regression indicated that histological grading (P=0.028), estrogen receptor(ER) expression (P=0.001) and elevated preoperative values of CA 15-3 (P=0.015) were independent prognostic factors for overall survival. Conclusions: Our study demonstrates that higher expression of preoperative serum CA15-3 or TPS was closely correlated with clinicopathology and overall survival, and CA15-3 before treatment can be used as an independent prognostic parameter in patients with primarily breast cancer. However, serum CEA had poor correlation with clinical prognostic factors.

Evaluation of serum big endothelin-1 for the diagnosis and prediction of disease recurrence in breast cancer patients

“…On the contrary CA15.3 failed to discriminate between the breast cancer and the control groups (AUC66.3%, p.05). This finding was in accordance with previous studies which emphasized that CA15.3 lack in sensitivity for the early diagnosis of breast cancer [32,33]. In the study population both biochemical markers were not able to predict early breast cancer metastasis.…”

“…This observation was in accordance with other studies [16,21] that stated that there was no correlation between circulating big ET-1 and tumor size, thus the increase in big ET-1 was due to a difference in production and secretion rate of tumors. Besides, the lack of a correlation between CA15.3 and the clinicopathological characteristics was due to cytokines which depend on the neoplasm activity and not on the stage of the disease or the histological type of the tumor [25,[30][31][32].…”