Abstract
Background: Serologic tumor markers such as CA15-3, CEA and TPS have been used for decades to manage patients with breast cancer. Despite the frequent use of these markers, the prognostic significance of these markers remains indeterminate. Patients and methods: We retrospectively analyzed and followed up a set of 361 patients with Stages I~III breast cancer, from January 2001 to February 2011. Serumal CA15-3 and CEA levels were measured by electrochemistry (ELC), and serumal TPS was analyzed by enzyme-linked immunosorbent assays (ELISA). We explored the relationship between preoperative serologic tumor markers and clinicopathological parameters, the correlation between CA15-3, CEA or TPS levels with overall survival, and their impact on prognosis. Results: First, at the univariate analysis, higher preoperative serum CA15-3 was significantly associated with older age of onset (?45 years, P=0.049), and the expression of TPS was related with some traditional prognostic factors such as tumor size (P=0.030), histologic grade (P=0.001) and lymph node status (P=0.008). Second, overall survival were significantly shorter among patients with elevated preoperative serum CA15-3 (P=0.000) or TPS (P=0.038) respectively. Finally, multivariate Cox regression indicated that histological grading (P=0.028), estrogen receptor(ER) expression (P=0.001) and elevated preoperative values of CA 15-3 (P=0.015) were independent prognostic factors for overall survival. Conclusions: Our study demonstrates that higher expression of preoperative serum CA15-3 or TPS was closely correlated with clinicopathology and overall survival, and CA15-3 before treatment can be used as an independent prognostic parameter in patients with primarily breast cancer. However, serum CEA had poor correlation with clinical prognostic factors.
Highlights
Breast cancer is a significant health problem world wide, mainly affecting women, the incidence of breast cancer has increased rapidly over the past few decades
We explored the relationship between preoperative serologic tumor markers and clinicopathological parameters, the correlation between CA15-3, Carcinoembryonic antigen (CEA) or Tissue polypeptide specific antigens (TPS) levels with overall survival, and their impact on prognosis
First, at the univariate analysis, higher preoperative serum CA15-3 was significantly associated with older age of onset (≥45 years, P=0.049), and the expression of TPS was related with some traditional prognostic factors such as tumor size (P=0.030), histologic grade (P=0.001) and lymph node status (P=0.008)
Summary
Breast cancer is a significant health problem world wide, mainly affecting women, the incidence of breast cancer has increased rapidly over the past few decades. The role of serum markers is less well established owing to the unsatisfactory evidence Serologic tumor markers such as CA15-3, CEA and TPS have been used for decades to manage patients with breast cancer. We explored the relationship between preoperative serologic tumor markers and clinicopathological parameters, the correlation between CA15-3, CEA or TPS levels with overall survival, and their impact on prognosis. Results: First, at the univariate analysis, higher preoperative serum CA15-3 was significantly associated with older age of onset (≥45 years, P=0.049), and the expression of TPS was related with some traditional prognostic factors such as tumor size (P=0.030), histologic grade (P=0.001) and lymph node status (P=0.008). Conclusions: Our study demonstrates that higher expression of preoperative serum CA15-3 or TPS was closely correlated with clinicopathology and overall survival, and CA15-3 before treatment can be used as an independent prognostic parameter in patients with primarily breast cancer. Serum CEA had poor correlation with clinical prognostic factors
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