Clinicopathological and Prognostic Significance of Cancer Antigen 15-3 and Carcinoembryonic Antigen in Breast Cancer: A Meta-Analysis including 12,993 Patients.

Xuan Li,Weidong Wei,Danian Dai,Bo Chen,Xiaoming Xie,Hailin Tang

doi:10.1155/2018/9863092

Xuan Li, Weidong Wei + Show 4 more

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https://doi.org/10.1155/2018/9863092

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Journal: Disease markers	Publication Date: Jan 1, 2018
Citations: 70	License type: CC BY 4.0

Affiliation: Sun Yat-sen University Cancer Center

Abstract

Purpose The prognostic role of serum cancer antigen 15-3 (CA15-3) and carcinoembryonic antigen (CEA) in breast cancer remains controversial. In this study, we conducted a meta-analysis to investigate the prognostic value of these two markers in breast cancer patients. Methods After electronic databases were searched, 36 studies (31 including information regarding CA15-3 and 23 including information regarding CEA) with 12,993 subjects were included. Based on the data directly or indirectly from the available studies, the hazard ratios (HRs) and odds ratios (ORs) and their 95% confidence intervals (CIs) were pooled according to higher or lower marker levels. Results Elevated CA15-3 or CEA was statistically significant with poorer DFS and OS in breast cancer (multivariate analysis of OS: HR = 2.03, 95% CI 1.76–2.33 for CA15-3; HR = 1.79, 95% CI 1.46–2.20 for CEA; multivariate analysis of DFS: HR = 1.56, 95% CI 1.06–1.55 for CA15-3; HR = 1.77, 95% CI 1.53–2.04 for CEA). Subgroup analysis showed that CA15-3 or CEA had significant predictive values in primary or metastasis types and different cut-offs and included sample sizes and even the study publication year. Furthermore, elevated CA15-3 was associated with advanced histological grade and younger age, while elevated CEA was related to the non-triple-negative tumor type and older age. These two elevated markers were all associated with a higher tumor burden. Conclusions This meta-analysis showed that elevated serum CA15-3 or CEA was associated with poor DFS and OS in patients with breast cancer, and they should be tested anytime if possible.

Highlights

Breast cancer has the highest incidence rate and second highest mortality rate among female cancers [1]; its survival prognosis concerns doctors and patients
Thirty-one studies provided the survival information of serum cancer antigen 15-3 (CA15-3), and its cut-off values ranged from 20.11 to 77 U/ml; twenty-three studies provide the survival information of serum carcinoembryonic antigen (CEA), and its Records identified through database (n = 1002)
The results demonstrated that patients aged ≤35 years had a higher rate of CA15-3 increase (OR = 1.83, 95% confidence intervals (CIs): 1.20–2.80, p = 0 05), while younger ages had a lower rate of CEA rise (OR = 0.52, 95% CI: 0.29–0.94, p = 0 03)

Summary

Introduction

Breast cancer has the highest incidence rate and second highest mortality rate among female cancers [1]; its survival prognosis concerns doctors and patients. Prognostic factors are those clinicopathological parameters that are associated with tumor outcomes. Serum markers can be achieved, and they play an important role in many malignant tumors [9,10,11], but their role in breast cancer remains controversial. There is some correlation between tumor markers and tumor clinicopathology [12], and when the acquisition of tissue specimens is not available, in some cases, these markers may offer useful information about the phenotype of the breast cancer at an early stage [13]. Serum tumor markers in breast cancer include cancer antigen 15-3 (CA15-3), cancer antigen 27.29 (CA27.29), carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), circulating extracellular domain of HER-2, and tissue polypeptide-specific antigen (TPS) [14, 15]

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