Öz
Amaç: Meme kanserinin ilk tanıda%10-15'i lokal ileri meme kanseridir. Meme kanserinde tümör belirleyicileri grubunda karsinoembriyonik antijen (CEA) ve kanser antijeni 15-3 (CA 15-3) büyük önem taşır. Biz bu çalışmada evre IIIB meme kanserlerinde tümör belirleyicilerinin hastaların takibinde lokal nüks ve uzak organ metastaz ile ilişkisini ortaya koymaya çalıştık.
Gereç ve Yöntemler: Ankara Onkoloji Hastanesi'ne 4 yıllık süre içerisinde başvuran evre IIIB meme kanseri olup neoadjuvan kemoterapi sonrası operabl olan 140 hasta retrospektif olarak incelendi.
Bulgular: Çalışmaya 140 hasta dahil edildi. Başvuru anında; 54'ünde (%38,5) CEA düzeyi normal sınırlarda iken, CA 15-3 düzeyi 72'sinde (%51,4) normal sınırlarda idi. Kemoterapi sonrası ve bu hastaların 60’ında (%69,7) CEA düzeyleri normal, 46'sında (%67,6) CA 15-3 düzeyi normal sınırlarda idi. Kemoterapi sonrası CEA düzeyindeki düşüş oranı ile CA 15-3 düzeyindeki düşüş oranı p'ye göre <0,05 olup anlamlı bulunmuştur.
Hastaların 116'sında (%82,8) CA 15-3 düzeyleri normalleşti. 3 yıllık takip süresinde lokal nüksü olan 48 hastanın 26'sında (%54,1) CEA düzeyi yüksek, 33'ünde (%68,7) CA 15-3 düzeyi yüksek, 37 'sinde (%77) ise CEA veya CA 15-3’ten herhangi birisinde yüksek değer saptandı.
Sonuç: Postoperatif takip döneminde tümör belirleyici düzeylerinde artış oluşan hastalarda 4-6 ay sonrasında lokal nüksün ve/veya uzak organ metastazının ortaya çıkması ihtimalinin anlamlı olarak arttığını bulduk.
Anahtar Kelimeler
Meme kanseri ileri evre CEA CA 15-3 lokal nüks uzak metastaz
Kaynakça
- Ahmed M. Kabel, Tumor markers of breast cancer: new prospectives, J. Oncol. Sci.2017; 3 (1) 5–11.
- Ahmed M. Kabel, Fahad H. Baali, Breast cancer: insights into risk factors, pathogenesis, diagnosis and management, J. Cancer Res. Treat.2015; 3 (2) 28–33.
- S.G. Wu, Z.Y. He, J. Zhou, et al, Serum levels of CEA and CA15-3 in different molecular subtypes and prognostic value in Chinese breast cancer, Breast.2014; 23 (1) 88–93.
- J.X. Hing, C.W. Mok, P.T. Tan, et al., Clinical utility of tumour marker velocity of cancer antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA) in breast cancer surveillance, Breast .2020;(52) 95–101.
- C. Van Poznak, M.R. Somerfield, R.C. Bast, et al., Use of biomarkers to guide decisions on systemic therapy for women with metastatic breast cancer: american society of clinical oncology clinical practice guideline, J. Clin. Oncol.2015; 33 (24) 2695–2704.
- B, Liang MM, Ye XB, Zhao WY. Association of CA 15-3 and CEA with clinicopathological parameters in patients with metastatic breast cancer. Mol Clin Oncol. 2015; Jan;3 (1):232-236.
- B. Geng, M.M. Liang, X.B. Ye, W.Y. Zhao, Association of CA 15-3 and CEA with clinicopathological parameters in patients with metastatic breast cancer, Mol. Clin. Oncol.2015; 3 (1) 232–236 .
- X. Li, D. Dai, B. Chen, H. Tang, X. Xie, W. Wei, Clinicopathological and prognostic significance of cancer antigen 15-3 and carcinoembryonic antigen in breast cancer: a meta-analysis including.2018; 12,993.
- R. Molina, J.M. Auge, B. Farrus, et al, Prospective evaluation of carcinoembryonic antigen (CEA) and carbohydrate antigen 15.3 (CA 15.3) in patients with primary locoregional breast cancer, Clin. Chem.2010; 56 (7) 1148–1157.
- J.S. Lee, S. Park, J.M. Park, J.H. Cho, S.I. Kim, B.W. Park, Elevated levels of serum tumor markers CA 15-3 and CEA are prognostic factors for diagnosis of metastatic breast cancers, Breast Cancer Res. Treat.2013; 141 (3) 477–484.
- X. Li, D. Dai, B. Chen, H. Tang, X. Xie, W. Wei, Determination of the prognostic value of preoperative CA15-3 and CEA in predicting the prognosis of young patients with breast cancer, Oncol. Lett.2018; 16 (4) 4679–4688.
- Y. Shao, X. Sun, Y. He, C. Liu, H. Liu, Elevated levels of serum tumor markers CEA and CA15-3 are prognostic parameters for different molecular subtypes of breast cancerPLoS ONE. 2015;10 (7).
- Jager W, Eibner K. Loner B ,et al. Serial CEA and CA 15-3 measurements during follow-up of breast cancer patients. Anti-cancerRes.2000; 20(6D):5179-82.
- Canizares F. Sola J, Perez M,Preoperative values of CA 15-3 and CEA as prognostic factors in breast cancer:a multivariate analysis.TumorBiol. 2001;22:273-81.
- Lumachi F, Brands AA, ErmaniM. et al. Sensitivity of serum tumor markers CEA and CA 15-3 in Breast cancer recurrence sandcor relation with different prognostic factors. Anti-cancerRes .2000;2014751-5.
- Soletormos G, HyltoftPetersen P, Progression criteria for cancer antigen 15.3 and carcinoembriyonic antigen in rnetastatic breast cancer compared by computer simulation of marker data-ClinChem.2000; 46:939-49.
- Cheung KL, Graves CR, Robertson JE. Tumor marker measurements in the diagnosis and monitoring of breastcancer. CancerTreatRev.2000; 26:91-102.
- J.X. Hing a c, C.W. Mok a c, P.T. Tan b, S.S. Sudhakar a, C.M. Seah a, W.P. Lee a c, S.M. Tan a Clinical utility of tumor marker velocity of cancer antigen 15–3 (CA 15–3) and carcinoembryonic antigen (CEA) in breast cancer surveillance The Breast Volume 52, August 2020;Pages 95-101.
- Dr. Diya Hasan Diagnostic impact of CEA and CA 15-3 on chemotherapy monitoring of breast cancer patients J Circ Biomark. 2022 Jan-Dec; 11: 57–63.
- S.Y. Bae 1, W. Lim 2, J. Jeong 3 et al ,8276P –The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients Annals of Oncology Volume 30, Supplement 5, October 2019, Page v93.
- M.J. Duffy, S. Shering, F. Sherry, E. McDermott, N O’Higgins, CA 15–3: a Prognostic Marker in Breast Cancer, Int. J. Biol. Markers.2000 ;15 (4) 330–333.
Öz
Aim: 10-15% of breast cancer is locally advancedbreastcancer at the time of initial diagnosis. Intergroup of tumor markers in breast cancer, carcinoembryonic antigen (CEA) andcancerantigen 15-3 (CA 15-3) are of great importance. Inthisstudy,we tried to reveal the relationshipbetweentumormarkers in stage IIIB breastcancerwithlocalrecurrenceanddistant organ metastasis in the follow-up of patients.
Material and Methods: 140 patientswithstage IIIB breastcancerwhowereadmitted to Ankara OncologyHospitalwithin4yearsandwereoperableafterneoadjuvantchemotherapywhere retrospectively analyzed.
Results: 140 patientswereincluded in thestudy. At the time of application, CEA levelwaswithinthe normal range in 54 (38.5%), the CA 15-3 levelwaswithinthe normal range in 72 (51.4%). Afterchemotherapyand in 60 (69.7%) of thesepatients, the CEA levelswere normal. In 46 (67.6%) of them, CA 15-3 levelwaswithin normal limits. The rate of decrease in CEA levelandthe rate of decrease in CA 15-3 levelafterchemotherapywas<0.05, and it wassignificant. CA 15-3 levelswerenormalized in 116 (82.8%) of thepatients. Duringthe 3-year follow-up period of 48 patientswithlocal recurrence, 26 (54.1%) had high CEA levels, 33 (68.7%) had high CA 15-3 levels, and 37 (77%) had high CEA or CA 15-3.
Conclusion:Wefound that the probability of occurrence of localrecurrenceand / or distant organ metastasisincreasedsignificantlyafter 4-6 months in patientswhosetumor marker levelswereincreased in thepostoperativefollow-upperiod.duringthepostoperativefollow-upperiod.
Anahtar Kelimeler
Breastcancer advanced stage CEA CA 15-3 local recurrence distant metastasis
Kaynakça
- Ahmed M. Kabel, Tumor markers of breast cancer: new prospectives, J. Oncol. Sci.2017; 3 (1) 5–11.
- Ahmed M. Kabel, Fahad H. Baali, Breast cancer: insights into risk factors, pathogenesis, diagnosis and management, J. Cancer Res. Treat.2015; 3 (2) 28–33.
- S.G. Wu, Z.Y. He, J. Zhou, et al, Serum levels of CEA and CA15-3 in different molecular subtypes and prognostic value in Chinese breast cancer, Breast.2014; 23 (1) 88–93.
- J.X. Hing, C.W. Mok, P.T. Tan, et al., Clinical utility of tumour marker velocity of cancer antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA) in breast cancer surveillance, Breast .2020;(52) 95–101.
- C. Van Poznak, M.R. Somerfield, R.C. Bast, et al., Use of biomarkers to guide decisions on systemic therapy for women with metastatic breast cancer: american society of clinical oncology clinical practice guideline, J. Clin. Oncol.2015; 33 (24) 2695–2704.
- B, Liang MM, Ye XB, Zhao WY. Association of CA 15-3 and CEA with clinicopathological parameters in patients with metastatic breast cancer. Mol Clin Oncol. 2015; Jan;3 (1):232-236.
- B. Geng, M.M. Liang, X.B. Ye, W.Y. Zhao, Association of CA 15-3 and CEA with clinicopathological parameters in patients with metastatic breast cancer, Mol. Clin. Oncol.2015; 3 (1) 232–236 .
- X. Li, D. Dai, B. Chen, H. Tang, X. Xie, W. Wei, Clinicopathological and prognostic significance of cancer antigen 15-3 and carcinoembryonic antigen in breast cancer: a meta-analysis including.2018; 12,993.
- R. Molina, J.M. Auge, B. Farrus, et al, Prospective evaluation of carcinoembryonic antigen (CEA) and carbohydrate antigen 15.3 (CA 15.3) in patients with primary locoregional breast cancer, Clin. Chem.2010; 56 (7) 1148–1157.
- J.S. Lee, S. Park, J.M. Park, J.H. Cho, S.I. Kim, B.W. Park, Elevated levels of serum tumor markers CA 15-3 and CEA are prognostic factors for diagnosis of metastatic breast cancers, Breast Cancer Res. Treat.2013; 141 (3) 477–484.
- X. Li, D. Dai, B. Chen, H. Tang, X. Xie, W. Wei, Determination of the prognostic value of preoperative CA15-3 and CEA in predicting the prognosis of young patients with breast cancer, Oncol. Lett.2018; 16 (4) 4679–4688.
- Y. Shao, X. Sun, Y. He, C. Liu, H. Liu, Elevated levels of serum tumor markers CEA and CA15-3 are prognostic parameters for different molecular subtypes of breast cancerPLoS ONE. 2015;10 (7).
- Jager W, Eibner K. Loner B ,et al. Serial CEA and CA 15-3 measurements during follow-up of breast cancer patients. Anti-cancerRes.2000; 20(6D):5179-82.
- Canizares F. Sola J, Perez M,Preoperative values of CA 15-3 and CEA as prognostic factors in breast cancer:a multivariate analysis.TumorBiol. 2001;22:273-81.
- Lumachi F, Brands AA, ErmaniM. et al. Sensitivity of serum tumor markers CEA and CA 15-3 in Breast cancer recurrence sandcor relation with different prognostic factors. Anti-cancerRes .2000;2014751-5.
- Soletormos G, HyltoftPetersen P, Progression criteria for cancer antigen 15.3 and carcinoembriyonic antigen in rnetastatic breast cancer compared by computer simulation of marker data-ClinChem.2000; 46:939-49.
- Cheung KL, Graves CR, Robertson JE. Tumor marker measurements in the diagnosis and monitoring of breastcancer. CancerTreatRev.2000; 26:91-102.
- J.X. Hing a c, C.W. Mok a c, P.T. Tan b, S.S. Sudhakar a, C.M. Seah a, W.P. Lee a c, S.M. Tan a Clinical utility of tumor marker velocity of cancer antigen 15–3 (CA 15–3) and carcinoembryonic antigen (CEA) in breast cancer surveillance The Breast Volume 52, August 2020;Pages 95-101.
- Dr. Diya Hasan Diagnostic impact of CEA and CA 15-3 on chemotherapy monitoring of breast cancer patients J Circ Biomark. 2022 Jan-Dec; 11: 57–63.
- S.Y. Bae 1, W. Lim 2, J. Jeong 3 et al ,8276P –The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients Annals of Oncology Volume 30, Supplement 5, October 2019, Page v93.
- M.J. Duffy, S. Shering, F. Sherry, E. McDermott, N O’Higgins, CA 15–3: a Prognostic Marker in Breast Cancer, Int. J. Biol. Markers.2000 ;15 (4) 330–333.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Genel Cerrahi |
| Bölüm | Özgün Makale |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Aralık 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 14 Sayı: 4 |
Kaynak Göster
e-ISSN: 2149-8296
The content of this site is intended for health care professionals. All the published articles are distributed under the terms of
Creative Commons Attribution Licence,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.