Role of Ca 15-3 in patients with biochemically suspected prostate cancer and multiple negative ultrasound-guided prostate biopsies

Abstract

Ca 15-3 is an aspecific tumor marker characteristic of cancer proliferation. Elevated serum levels seem to be closely correlated with cancer progression in non-urological tumors. This study assessed the role of Ca 15-3 as an aspecific tumor marker in patients with borderline prostate-specific antigen (PSA) biochemically suspected of prostate cancer (PCa) and with multiple negative prostate biopsies.The study is based on prospective analysis of 103 patients: (a) 33 patients (group A) presented lower urinary tract symptoms secondary to BPH with normal serum PSA values, DRE and TRUS negative for suspected PCa; (b) 31 patients (group B) with histologically diagnosed PCa; (c) 39 patients (group C) with borderline serum PSA values, DRE and TRUS normal, two ultrasound (US)-guided random prostate biopsies negative for PCa. Ca 15-3 was determined in the entire study series by the IRMA method, using as range the values proposed for the investigated non-urological tumors (38 UI/l).Ca 15-3 was within normal range in all group A patients (control), while the values were elevated in 27/31 of group B patients (PCa) and in 11/39 of group C (PCa suspected) patients. A third biopsy was performed in all 39 group C patients with borderline PSA and it was PCa-positive in 13 patients (33.3%, subgroup C3). In this series Ca 15-3 was increased in 9 of 13 patients (subgroup C3a), while the remaining four patients (subgroup C3b) presented values within the normal range. On 26 group C patients who were negative for PCa to third biopsy (subgroup C4), 24 patients had Ca 15-3 levels within normal range (subgroup C4a) with histologic findings of BPH in 23 cases and granulomatous chronic prostatitis in one case, while two patients (subgroup C4b) had elevated Ca 15-3 concentrations associated with lymphoplasmacytic chronic prostatitis.We hypothesize that Ca 15-3, as a specific tumor marker, could be an interesting and inexpensive second step diagnostic tool for PCa in patients with borderline PSA and multiple negative prostate biopsies, as it could indicate whether a repeated biopsy should be performed in a short time, having excluded other concomitant tumors. However, further prospective studies will be necessary to confirm this hypothesis.

Diagnostic value of serum CA125, CA19-9 and CA15-3 in endometriosis: A meta-analysis

“…Elevated serum concentrations of cancer antigen [CA] 125, CA19-9, and CA15-3 are observed in some carcinomas, 5–7 and are considered oncofetal antigens, or serum tumour markers. Serum CA125 concentration was first used in the diagnosis of endometriosis in 1983, 8 followed by several other biomarkers including CA19-9, CA15-3, copeptin, interleukin (IL)-6 and IL-8.…”

“…2,3 Although the most accurate diagnostic method is histological examination of laparascopically excised lesions, less-invasive auxiliary tests have been developed, including the use of biochemical markers. 4 Elevated serum concentrations of cancer antigen [CA] 125, CA19-9, and CA15-3 are observed in some carcinomas, [5][6][7] and are considered oncofetal antigens, or serum tumour markers. Serum CA125 concentration was first used in the diagnosis of endometriosis in 1983, 8 followed by several other biomarkers including CA19-9, CA15-3, copeptin, interleukin (IL)-6 and IL-8.…”

Increased Serum CA-15.3 Levels in Patients with Megaloblastic Anemia due to Vitamin B₁₂ Deficiency

“…Increased serum CA-15.3 levels have also been reported in patients with various solid tumors of epithelialcell origin, such as in 45% of the patients with ovarian cancer, in 25% of those with lung cancer, in 30% of hepatocellular carcinoma, in 20–25% of colon cancer etc. [8, 9], in the majority of patients with prostatic cancer [10]as well as in sporadic cases of pancreatic cancer [11], in cases of chondroid syringoma [12]and in some hematological malignancies (<5% of the cases) [8, 13]. A mild-to-moderate increase of serum CA-15.3 has been noted among normal subjects, mainly in association with aging [14], pregnancy, with no difference in relation to normal or pathological pregnancy [15]and in various nonmalignant diseases and conditions [16], while it appears that renal failure does not significantly influence serum levels of this mucin [17].…”

Prostate cell lines as models for biomarker discovery: Performance of current markers and the search for new biomarkers

“…The amount of β‐human chorionic gonadotrophin protein is increased in the serum and urine of patients with prostate cancer, and this biomarker has been associated with low‐grade disease , however β‐human chorionic gonadotrophin is unable to distinguish patients at risk of mortality, and elevated amounts of this protein in serum or urine are only observed in a small proportion of patients (4–10%) . The carbohydrate antigen biomarkers CA 15‐3, CA 19‐9, C‐reactive protein, and carcinoma embryonic antigen, whilst having some prognostic capabilities, provide minimal diagnostic value due to their low specificity and the need for a prostate biopsy for this analysis ; and are therefore not being considered for use in prostate cancer detection . Thus, the analysis of serum PSA levels combined with digital rectal examination remains the recommended methods for diagnosis .…”