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Abstract

The role of circulating tumor markers in providing prognostic information has not been widely studied. In the current study, serum levels of the carbohydrate antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA) were determined preoperatively in 364 breast cancer patients with no clinical signs of metastasis. The prognostic relevance of these markers for recurrence (175/364) and death of disease (104/175) was determined by Cox multivariate analysis, including the comparison with classical prognostic factors. High levels of both tumor markers were associated with aneuploid tumors with high S-phase fraction and high ornithine decarboxylase activity. CA 15-3 was highly associated with the number of positive lymph nodes and peritumoral lymphatic or blood vessel invasion. No significant associations were found between CEA or CA 15-3 levels and histologic grade, necrosis and steroid receptor status. In univariate analysis, preoperative values, using optimum cutoff values of CA 15-3 (40 U/ml) and CEA (6 ng/ml), were statistically significant for relapse-free survival and overall survival. In multivariate analysis, only node status, DNA ploidy and ornithine decarboxylase activity were independent predictors for relapse-free survival; the estrogen receptor status was a predictor of overall survival. In node-negative patients, ornithine decarboxylase activity was the only factor selected for relapse-free survival. In node-positive patients, the number of lymph nodes and DNA ploidy were the only variables selected for relapse-free survival or overall survival. Estrogen receptor and ornithine decarboxylase activity were excluded for relapse-free survival, but were significant prognostic factors for overall survival.

Preoperative Serum Carcinoembryonic Antigen as a Marker for Predicting the Outcome of Three Cancers

“…Normally, serum CEA concentrations are below 5 ng/mL. In contrast to healthy conditions, elevated serum CEA levels have been found in other types of cancers aside from colorectal cancer, to include gastric,18 pancreatic,19 breast,9,16,20 and genitourinary cancers 10. According to the 2014 Facts and Figures Annual Report generated by the American Cancer Society, breast cancer is the most frequent form of cancer in women.…”

“…However, CEA is a nonspecific tumor marker and increases in CEA levels have been detected in several cancers, such as gastrointestinal tract, breast,9 and male genitourinary cancer 10. Presently, various studies have examined the clinical value of CEA in diagnosing cancer in patients with gastric,11 pancreatic,12,13 or breast cancer,9 with exception to colorectal cancer.…”

“…However, CEA is a nonspecific tumor marker and increases in CEA levels have been detected in several cancers, such as gastrointestinal tract, breast,9 and male genitourinary cancer 10. Presently, various studies have examined the clinical value of CEA in diagnosing cancer in patients with gastric,11 pancreatic,12,13 or breast cancer,9 with exception to colorectal cancer. The tumor markers CA 724, CA 242, CA 199, and CEA were evaluated in patients with gastric cancer in a study, and it was found that the combination of these 4 tumor markers could potentially be used as the diagnostic index for gastric cancer 14.…”

Nomograms for Predicting the Prognostic Value of Pre-Therapeutic CA15-3 and CEA Serum Levels in TNBC Patients

“…As expected, distinctly higher tumor biomarker levels were noted in the tumor status and TNM staging, suggesting a relationship between high levels of tumor biomarkers and tumor load (Table 1). Because the level of CA15-3 was closely correlated with the metastasis of the venous and lymphatic vasculature[34], a high CA 15–3 concentration at the beginning could predict a worse breast cancer outcome[35]. In particular, the prognostic implication of TNM staging was completely ruled out in the multivariate analysis with the incorporation of other classical predictive elements such as tumor status and nodal status (Table 3).…”

MUC1 (CA27.29) before and after Chemotherapy and Prognosis in High-Risk Early Breast Cancer Patients

“…MUC1 is a prognostic marker in both early [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ] and advanced BC [ 19 , 20 ]. In most studies in patients with non-metastatic BC, blood for MUC1 assessment has been obtained preoperatively.…”