A CLINICO-PATHOLOGICAL STUDY OF CARCINOMA BREAST WITH SPECIAL REFERENCE TO SERUM CEA LEVELS & ITS RELATIONSHIP WITH TREATMENT

Abstract

BACKGROUND: Carcinoembryonic antigen (CEA) is used as a tumor marker for breast cancer (BC) & follow up of patients pre- or post- chemotherapy. In order to better dene clinical usefulness of CEA in breast cancer patients (BCP) we determined its baseline pre-treatment levels and correlated them with main parameters of primary tumor and metastases.PATIENTS AND METHODS: The main experimental group consisted of 53 females with histologically conrmed diagnosis of BC. The obtained results have been compared with those of three follow-up groups: pre-operative, immediate post-operative and 2nd follow up Post operative patients with other types and locations of cancer. In both cancer groups the parameters of primary tumor (size, grade) and metastases (time interval to metastases, location, size) have been determined. Circulating levels of CEA were measured by the means of sandwich ELISA assay. Results were processed by means of t-test, two way analysis of variance in p value. RESULTS: Baseline levels of CEA in BCP were signicantly higher than in healthy women (p < 0.0001), and in patients with other types and locations of cancer (p < 0.007). There also was signicant difference (p < 0.001) between serum CEA in other cancer patients and healthy women. Baseline CEA levels were in signicant positive correlation with the size of primary tumor both in all BCP (p < 0.03) and in hyperCEA BCP (p < 0.002), while in other cancer patients such a correlation did not exist. There was no correlation between CEA and degree of differentiation of primary tumor either in BCP or in other cancer patients. The average circulating levels of CEA in metastatic BCP were signicantly higher (p < 0.03) in comparison to non-metastatic patients, while in other cancer patients such a difference did not show up. There was signicant correlation (p < 0.0001) between circulating CEA and the size of metastases in all BCP and in subgroup of hyperCEA BCP, while in other cancer patients it was not a case. There was no correlation between serum CEA and other two metastatic parameters either in BCP or in other cancer patients. CEA does not have high tumor specicity for BC CONCLUSIONS: 1 since its baseline levels may be elevated in other types of cancer . Circulating levels of CEA in BCP are directly dependable on the size of both primary and metastatic tumor. CEA is a tumor antigen of less differentiated cancer cells. Circulating CEA is a good prognostic marker for patients with metastatic BC.