Evaluation of serum tumor markers in assessing the efficacy of TP (Paclitaxel plus Carboplatin) chemotherapy combined with trastuzumab and pertuzumab dual target therapy in HER2-positive breast cancer.

Serum tumor markers (CEA, SLX, CA125) were evaluated in 123 patients with active pulmonary tuberculosis. The results were as follows: Elevated serum CEA, SLX and CA125 levels were found in 16.9%, 39.5% and 44.4%, respectively, of patients with active pulmonary tuberculosis. Markedly elevated serum CA125 levels were found in some cases. On chest X-ray films, the factors associated with elevation of serum tumor marker levels were examined. Serum CEA and SLX levels were correlated with the extent of disease. Pleural effusion had no influence on serum tumor marker levels. Serum SLX levels were higher in patients without a tuberculous cavity than in those with a tuberculous cavity. After therapy with antituberculous drugs, the mean values of serum SLX and CA125 levels significantly decreased. The decrease in mean value of serum CEA levels was not significant, but in 4 of 8 cases, elevated serum CEA levels were normalized after therapy. On the other hand, two cases with increased serum CEA or SLX level died of respiratory failure. These results suggest that to follow up patients with elevated serum tumor markers is useful for the evaluation of disease activity of pulmonary tuberculosis. Further elevation of serum tumor marker levels after antituberculous therapy may indicate the presence of cancer or deterioration of the disease.

AIMTo retrospectively evaluate the factors that influence long-term outcomes of duodenal papilla carcinoma (DPC) after standard pancreaticoduodenectomy (SPD).METHODSThis is a single-centre, retrospective study including 112 DPC patients who had a SPD between 2006 and 2015. Associations between serum levels of CA19-9 and CEA and various clinical characteristics of 112 patients with DPC were evaluated by the χ2 test and Fisher’s exact test. The patients were followed-up every 3 mo in the first two years and at least every 6 mo afterwards, with a median follow-up of 60 mo (ranging from 4 mo to 168 mo). Survival analysis was conducted using the Kaplan-Meier survival and Cox proportional hazards model analysis. The difference in survival curves was evaluated with a log-rank test.RESULTSIn 112 patients undergoing SPD, serum levels of CA19-9 was associated with serum levels of CEA and drainage mode (the P values were 0.000 and 0.033, respectively); While serum levels of CEA was associated with serum levels of CA19-9 and differentiation of the tumour (the P values were 0.000 and 0.033, respectively). The serum levels of CA19-9 and CEA were closely correlated (χ² = 13.277, r = 0.344, P = 0.000). The overall 5-year survival was 50.00% for 112 patients undergoing SPD. The Kaplan-Meier survival analysis showed that increased serum levels of CA19-9, CEA, and total bilirubin were correlated with a poor prognosis, as well as a senior grade of infiltration depth, lymph node metastases, and TNM stage(the P values were 0.033, 0.018, 0.015, 0.000, 0.000 and 0.000, respectively). Only the senior grade of infiltration depth and TNM stage retained their significance when adjustments were made for other known prognostic factors in Cox multivariate analysis (RR = 2.211, P = 0.022 and RR = 2.109, P = 0.047).CONCLUSIONFor patients with DPC, the serum levels of CA19-9 and CEA were closely correlated, and play an important role in poor survival. Increased serum levels of total bilirubin and lymph node metastases were also correlated with a poor prognosis. The senior grade of infiltration depth and TNM stage can serve as independent prognosis indexes in the evaluation of patients with DPC after SPD.

Objective: To investigate the relationship between serum tumor markers and the severity of silicosis. Methods: In April 2024, A cluster sampling was conducted on the pulmonary rehabilitation centers in Jiangsu Province. A retrospective analysis was carried out on 629 patients who received follow-up physical examinations for pneumoconiosis from April to November 2023 at the selected rehabilitation centers. 281 healthy volunteers who underwent occupational health examinations at our institution were selected as the blank control group, and 384 dust exposed workers from a coal mining enterprise were selected as the dust exposed control group. Detect the levels of peripheral bloodtumor markers carcinoembryonic antigen CEA, carbohydrate antigen CA199, and neuron-specific enolase NSE in specimens. Measure the patient's forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), and lactate acid dehydrogenase (LDH) levels in the blood. The Jonckheere-Terpstra test, a non-parametric test for ordered independent samples, was used to compare the expression levels of tumor markers among multiple groups. Spearman's rank correlation analysis was adopted to explore the correlations between serum tumor markers and the staging of pneumoconiosis as well as lung function parameters. Results: Among the 629 patients with pneumoconiosis, 454 were in stage Ⅰ, 150 were in stage Ⅱ, 25 were in stage Ⅲ. There were significant differences in serum CEA, CA199 and NSE levels among patients with different periods of pneumoconiosis, blank control group and dust-exposed control group (P<0.001). Serum CEA, CA199 and NSE levels were positively correlated with pneumoconiosis stage (P<0.05). There is a negative correlation between serum CA199 levels and FEV(1)% in patients with pneumoconiosis (r=-0.082, P<0.05). The serum CA199 level was positively correlated with LDH in patients with pneumoconiosis (r=0.108, P<0.05) .The serum NSE level of pneumoconiosis patients was negatively correlated with FVC% (r=-0.079, P<0.05) .There is a positive correlation between serum NSE levels and LDH in patients with pneumoconiosis (r=0.435, P<0.05) . Conclusion: The serum CA199 and NSE of pneumoconiosis patients are directly related to the severity and stage of the disease, which have practical significance in judging the treatment effect of pneumoconiosis patients and monitoring the development of the disease.

Since renal failure causes decrease in tumor marker excretion, use of these markers in cancer care and treatment in patients with renal insufficiency or hemodialysis is controversial. The aim of this study was to investigate differences of serum levels of tumor markers CA15-3, AFP, CA19-9 and CEA in patients with impaired renal function. A total of 100 patients referred to the Tabriz Immam Reza and Amiralmomenin hospital from June 2010 to November 2011 were selected for study. Subjects were divided to 3 groups of healthy, dialysis and renal failure but non hemodialysis cases, the last category being re-grouped based on creatinine clearance. No significant relationship between different groups in serum levels of CEA (P=0.99) and CA19-9 (P=0.29) tumor markers was found. A significant correlation was observed between serum levels of AFP (P<0.001) and CA15-3 (P<0.001) and also a tendency between creatinine clearance and CEA (r=0.05, P=0.625). Creatinine clearance significantly correlated with AFP (P<0.001, r=0.53) and CA15-3 (p=0.00, r=-0.412), but not CA19-9 (P=0.089, r=-0.171). According to results of this study it appears that use of tumor markers in patients with impaired renal function should be performed with special precautions.

Liver metastases are associated with poor prognosis in patients with colorectal cancer (CRC). The objective of this study is to determine the possible indicators in identifying the predictive value of serum CEA, CA19-9 and CA-125 in diagnosis of liver metastases from CRC in the Chinese population. We randomly selected 101 CRC patients with liver metastases and 81 patients without liver metastases. Several clinical pathological factors were analyzed for the correlation with liver metastases. The predictive value of CEA, CA19-9 and CA-125 for liver metastases from CRC was evaluated. There was no significant difference in gender, age, hepatitis B history, serum AFP level or lesion location. Patients with liver metastases had a tendency to have higher serum CEA, CA19-9 and CA-125 level. Multivariate analysis revealed that serum CEA level (p<0.001), CA19-9 level (p<0.001) and CA-125 level (p=0.001) were independent prognostic predictors for liver metastases. Combination of CEA, CA19-9 and CA-125 can enhance their sensitivity in diagnosis of synchronous and metachronous liver metastases. Serum CA19-9 level, combined test of CA19-9 and CA-125, combined test of triple markers have higher sensitivities in synchronous metastasis than those in metachronous metastasis. Combination test would enhance the sensitivities of serum CEA, CA19-9 and CA-125 levels, which are important in predicting liver metastases from CRC in the Chinese population, either synchronous or metachronous.

Serum LDH, CEA, and CA19-9 levels are important tumor markers in pancreatic cancer. The purpose of this study was to evaluate the clinical significance of serum LDH, CEA, and CA19-9 levels in metastatic pancreatic cancer (MPC) receiving gemcitabine-based chemotherapy. In this retrospective study, we analyzed the outcome of 196 MPC patients who are treated with gemcitabine-based chemotherapy in our clinic. Positivity rates of serum LDH, CEA, and CA19-9 were 22, 40, and 83 %, respectively. Likewise, the rates of very high serum levels of tumor markers were correlated with these positivity rates (9 % for LDH, 30 % for CEA, and 55 % for CA19-9). The serum LDH levels were significantly higher in older patients (p = 0.05) and also in the patients with large tumors (p = 0.05), hepatic metastasis (p = 0.01), hypoalbuminemia (p = 0.01), and unresponsive to chemotherapy (p = 0.04). However, no correlation was found between both serum CEA and CA19-9 levels and possible prognostic factors (p > 0.05). The significant relationships were found between the serum levels of CEA and CA19-9 (r s = 0.24, p = 0.004), and serum LDH and CEA (r(s) = 0.193, p = 0.02). But, there was no correlation between serum LDH and CA19-9 levels (p = 0.39). One-year overall survival rate was 12.8 % (95 % CI 8-18). Increased serum levels of all the tumor markers significantly had adverse affect on survival (p = 0.001 for LDH, p = 0.002 for CEA, and p = 0.007 for CA19-9). However, no difference was observed in between high levels and very high levels of serum markers for all tumor markers (p > 0.05). Patients with normal serum levels of all three tumor markers had better outcome than others (p = 0.002) and those with normal serum LDH and CEA levels (whatever CA19-9) levels had associated with better survival compared with other possible alternatives (p < 0.001). Serum levels of LDH, CEA, and CA19-9 had significant affect on survival in MPC patients.

To investigate the relationship between the serum levels of CEA, CA19-9, CA24-2, CA72-4, and AFP in patients with gastric cancer (GC) and their clinicopathological characteristics; to analyze the efficacy of these tumor markers in evaluating the prognosis of GC. Overall, 389 patients with GC either located in the gastric cardia (132), the pyloric antrum (112) or the body of the stomach (145) were included in the study. Serum levels of CEA, CA19-9, CA72-4, and AFP were detected with the ECLIA method, while CA24-2 was measured with ELISA. First, the serum level of CEA in GC patients with a cardia-located cancer was significantly higher than in patients with pyloric antrum-located cancer (p=0.050). CA72-4 level in patients with GC located in the gastric body was significantly higher than in patients with cardia and pyloric antrum-located cancers (p=0.042 and p=0.039, respectively). Secondly, serum CA19-9 and CA24-2 levels in females with cardia-located GC were significantly higher than those in males with the same type of tumor (p=0.037 and p=0.033, respectively). Additionally, for females with gastric body-located GC the levels of CEA and CA72-4 were significantly higher than those in male patients with the same type of tumor (p=0.047 and p=0.048, respectively). Conversely, in female GC patients with pyloric antrum-located cancer the serum levels of CA19-9 and CA24-2 were significantly lower than those in male patients with the same type of cancer (p=0.013 and p=0.007, respectively). Moreover, CEA, CA19-9, CA24-2, and CA72-4 levels were strongly related to TNM grade and histological anatomy stage, whereas CEA and CA72-4 levels were strongly related to lymph node stage (p=0.000 and p=0.042, respectively). Patients with vascular embolism had higher serum levels of CEA, CA19-9, CA24-2, and CA72-4 compared with patients without vascular embolism (p=0.005, p=0.031, p=0.007, and p=0.014, respectively). In patients with distant metastases and ascites the levels of CEA, CA19-9, and CA24-2 were higher than in patients without these conditions (p=0.003, p=0.001, p=0.001, p=0.016, p= 0.011, and p=0.030, respectively). Serum CEA, CA19-9, and CA24-2 levels showed correlations with tumor invasive depth and growth types (p=0.001, p=0.040, and p=0.035, respectively). Patients with lump and catheter tumor growth types had significantly higher AFP levels than patients with invasion and anabrosis growth types (p=0.034 and p=0.005, respectively). Tumor size was correlated with the preoperative serum levels of CEA, AFP, and CA72-4 (p=0.007, p=0.020, and p=0.008, respectively). Additionally multiple linear regression analysis showed that preoperative levels of CEA and CA72-4 were correlated to TNM stages, CA19-9 and CA24-2 levels were correlated to both gender and distant metastasis, and AFP was correlated only to ascites. During follow-up there were 115 deaths. Median survival time for GC patients with negative preoperative CEA was 18.07 months, and was 10.97 months for patients with preoperative CEA positive levels (p=0.0005). Similarly, the median survival time for GC patients with negative preoperative CA72-4 was 33.60, and was 16.03 months for patients with preoperative CA72-4 positive levels (p=0.0041). The preoperative levels of CEA, CA19-9, CA24-2, CA72-4, and AFP were closely related to TNM grade, gender, distant metastasis and ascites. These makers seem to play important roles in predicting recurrence and metastasis, and in evaluating prognosis.

Background: Amphiregulin is a ligand for the epidermal growth factor receptor (EGFR). Human epidermal growth factor receptor 2 (HER2) shares common signal pathways and forms a heterodimer with EGFR. In this study, we investigated the effect of amphiregulin on trastuzumab therapy in HER2-positive breast cancer. Methods: We analyzed serum amphiregulin levels by enzyme-linked immunosorbent assay (ELISA) from baseline serum samples obtained from HER2-positive metastatic breast cancer patients who received first-line trastuzumab plus taxane chemotherapy. In addition, in vitro experiments were performed to elucidate the biologic mechanism of clinical findings related to amphiregulin using SK-BR-3 and BT-474 cell lines. Results: Between October 2004 and July 2009, a total of 50 women with HER2-positive metastatic breast cancer were consecutively enrolled. The median age was 47 years (range, 27-72 years). Eighteen patients (36.0%) received weekly paclitaxel plus trastuzumab, 24 patients (48.0%) tri-weekly paclitaxel plus trastuzumab, and 8 patients (16.0%) tri-weekly docetaxel plus trastuzumab. Among 43 patients with measurable lesions, the response rate (RR) was 76.7%. The median follow-up duration was 29.2 months (range, 0.7-63.3 months). The median progression-free survival (PFS) was 17.6 months (95% confidence interval (CI), 13.4-21.9 months). The median overall survival (OS) was 47.0 months (95% CI, 35.3-58.6 months). The median serum amphiregulin level was 1.0 ng/mL with a maximum level of 4.4 ng/mL. Patients with high serum amphiregulin levels (≥0.5 ng/mL) had significantly shorter PFS (p=0.018) along with a tendency toward lower RR (p=0.237) and shorter OS (p=0.529) than the others. The in vitro colony forming assay demonstrated that the addition of amphiregulin resulted in increased proliferation of both SK-BR-3 and BT-474 cells. In addition, the anti-proliferative effect of trastuzumab was decreased in the presence of amphiregulin in both SK-BR-3 and BT-474 cells. The Western blot analysis showed that amphiregulin increased the phosphorylation of Akt and its downstream molecules in both SK-BR-3 and BT-474 cells. In addition, in the presence of amphiregulin, sustained phosphorylation of Akt and its downstream molecules was observed after trastuzumab treatment in both SK-BR-3 and BT-474 cells. Conclusions: High serum amphiregulin levels (≥0.5 ng/mL) predicted disease progression after first-line trastuzumab plus taxane chemotherapy in patients with HER2-positive metastatic breast cancer. Amphiregulin promoted the proliferation of HER2-positive breast cancer cells in vitro and induced trastuzumab resistance by activating PI3K/Akt pathway. Our results suggest that the measurement of serum amphiregulin levels by ELISA may provide additional information for the clinical outcome of trastuzumab-based chemotherapy in patients with HER2-positive breast cancer. Citation Format: Ji-Won Kim, Young Seok Joung, Ahrum Min, Hyun-Jin Nam, Jee Hyun Kim, Seock-Ah Im, Kyung-Hun Lee, Jin-Soo Kim, Tae-Yong Kim, Sae-Won Han, Yoon Kyung Jeon, Do-Youn Oh, Tae-You Kim, In Ae Park. Amphiregulin confers trastuzumab resistance by activating PI3K/Akt pathway in HER2-positive breast cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2386. doi:10.1158/1538-7445.AM2013-2386

CA19-9 and CEA are associated with gastrointestinal malignancy as adhesion molecules. We measured serum CA19-9 and CEA levels in 328 patients with colorectal cancer. Both serum CA19-9 and CEA levels correlated significantly with recurrence and survival, respectively. Serum CA19-9 levels correlated significantly with survival according to Astler-Coller stage and multivariate analysis. Serum CEA levels showed no such correlations, although the combination of CEA with CA19-9 improved the sensitivity for predicting recurrence. Assessment of serum CA19-9 levels is more important than that of CEA in the clinical management of patients with colorectal cancer.

Background: CA19-9, CA125, AFP, CEA, and CA153 are common cancer biomarkers. This study aimed to detect the expression and assess clinical significance of these biomarkers in ovarian mature cystic teratomas (OMCT). Materials and Methods: The clinical dataof 312 resected patients with ovarian mature cystic teratoma referred to the third Hospital of Suzhou University from January 2008 to February 2014 were analyzed retrospectively. Levels of serum CA19-9, CA125, CA153, AFP, and CEA were detected. Results: Levels of serum CA19-9, CA125, AFP, and CEA were detected in all patients, but the level of serum CA153 was detected in 36 patients. The positive expression of these biomarkers above is 45.83%, 6.09%, 0.00%, 0.64%, and 2.78%, respectively. Ovarian tumor diameter in CA19-9 and CA 125 elevation is larger than that in negative group. The levels of serum CA19-9 and CA125 in multilocular ovarian tumor patients is higher than that in unilocular ovarian tumor patients. The level of serum CA19-9 in bilateral ovarian tumor patients is higher than that in unilateral patients. The level of CA19-9 in patients three months after operation decreased significantly compared with that before operation. Conclusions: The present study suggests that elevated CA 19-9 is probably the most reliable marker among many tumor markers in the OMCT. It is valuable for diagnosis and recurrence of OMCT.

In patients with chronic renal failure, whether they have had hemodialysis or not, the specificity of some of the serum tumor markers for the diagnosis of the corresponding tumors is decreased while others remain as valuable as they are in patients with normal kidney function. The detection of tumor markers is extensively used for the diagnosis of corresponding tumors. It has been recently shown that some tumor markers are higher in patients with chronic kidney disease (CKD) than in the normal population. The effects of renal function and hemodialysis were examined on serum levels of some of the tumor markers including CEA, CA199, CA125, AFP, CA153, CA724, CYFRA21-1, NSE, SCC-Ag, PSA, and fPSA. The 232 non-dialysis patients with CKD and 37 chronic uremic patients treated with maintenance hemodialysis were enrolled in this study. The 232 non-dialysis patients were divided into three groups according to their Ccr. In group 1, Ccr was [Symbol: see text] 25 mL/min. In group 2, Ccr was between 25 and 50 mL/min. In group 3, Ccr was [Symbol: see text] 50 mL/min. The male patients were also divided into three groups to compare the serum levels of PSA and fPSA among the three groups. Nine tumor markers in 37 uremic patients were tested. For comparison, 37 non-dialysis patients with similar Ccr of the same age and gender served as controls. There existed significant differences in serum levels of CEA, CA199, CYFRA21-1, NSE, and SCC-Ag among different Ccr groups and the markers bore a negative correlation with Ccr. There were no significant differences among the three groups in the serum concentrations of CA125, AFP, CA153, CA724, PSA and fPSA. The serum levels of CA125 and NSE were significantly higher (P < 0.01) in hemodialysis patients than in the nondialysis control patients. In patients with chronic renal failure, who were or were not on hemodialysis, the specificity of serum CEA, CA199, CYFRA21-1, NSE, CA125 and SCC-Ag for the diagnosis of the corresponding tumors was decreased while serum AFP, CA153, CA724, PSA and fPSA were as valuable as they were in patients with normal kidney function. Hemodialysis further increased the serum level of CA125 and NSE.

A case of extramammary Paget's disease with pedunculated tumor formation is reported. A 65-year-old woman had noticed a pruritic eruption on her left vulva 4 or 5 years ago. At her first visit, a pedunculated tumor about 3cm in diameter was found within an erythematous plaque intermingled with depigmented spots on her left vulva. Inguinal lymph nodes on both sides were palpable. Serum levels of CA19-9 as well as CEA were elevated. Histopathological examination revealed that the epidermis was permeated with Paget cells in groups, and the dermis was also infiltrated with a mass of Paget cells. Immunohistochemically, CEA and CA19-9 were expressed on tumor cells.After radical excision, serum levels of CEA and CA19-9 decreased rapidly. But 5 months after the operation, the tumor apparently recurred or metastasized because serum levels of CEA and CA19-9 became elevated again.

In this study, we determined whether serum tumor markers (STMs), including CA125, are associated with BRCA mutation status and if they can be used prognostically in sporadic ovarian cancer (SOC) and familial ovarian cancer (FOC). BRCA gene mutations were screened using next-generation sequencing (NGS) in 31 FOC and 66 SOC patients enrolled between 2013 and 2014. The serum levels of STM CEA, CA125, CA199, and HE4 were also measured in these patients to determine the prognostic potential of these markers and their association with BRCA mutations. Elevated levels of CA125, but not the other three STMs, were associated with FOC and BRCA mutations. Median progression-free survival (PFS) was significantly longer in patients with FOC, higher CA125 expression (>2000 U/mL), and BRCA mutation. Strikingly, the median PFS was not reached in either BRCA+/higher CA125 or FOC/higher CA125 patient groups and these patients had significantly longer PFS than those in other groups. As reported previously, we also detected more BRCA mutations in FOC than in SOC. No significant differences were observed in onset age, menopausal status, tumor stage, and distant metastasis between FOC and SOC patients or between BRCA+ and BRCA- patients. Elevated levels of serum CA125 are associated with FOC and BRCA mutations, which can be further exploited as a prognostic marker in OC.

Objective To evaluate the application of CEA, CA125 and cytokeratin 19 fragments (CYFRA21-1) in the diagnosis, pathological types and TNM stages of lung cancer. Methods It was collected 288 cases of hospitalized patients clinical data in Tang Du hospitals between January 2017 and April 2018. The concentrations of tumor markers in serum were detected by electrochemical immunofluorescence.It was analyzed the relationship between CEA, CA125 and CYFRA21-1 which were about lung cancer diagnosis, pathological types and TNM stages. Results Serum levels of CEA, CA125 and CYFRA21-1 in the lung cancer group were higher than those in the benign lung lesions group. CYFRA21-1 is the most valuable single tumor marker in different pathological types of lung cancer. The positive rates and serum levels of CEA and CA125 were of high application value in different TNM stages of lung cancer. Serum levels of CEA, CA125 and CYFRA21-1 are of great value in the early and late differentiation of lung cancer. Conclusion The CEA, CA125 and CYFRA21-1 are significant in the diagnosis of lung cancer. Among different pathological types, CYFRA21-1 is of great diagnostic value. The CEA, CA125 and CYFRA21-1 have different diagnostic values in TNM stage of lung cancer. Key words: Bronchogenic lung cancer; Lung tumor markers; TNM staging

The correlation between preoperative serum CEA and CA19-9 levels and postoperative survival was examined in 552 patients undergoing gastrectomy for gastric cancer in our department in a recent 7-year period. As a whole the serum CEA positive-rate was 18.5% and the serum CA19-9 positive-rate was 19.5%. The higher the clinical stage, the higher the positive-rate of each tumor marker elevated. The prognosis of CEA positive group and of CA19-9 positive group were significantly poorer than each negative group, especially when the serum CEA level was above 10ng/ml and when the serum CA19-9 level was above 50U/ml. Divided into each stage, there was no significant difference in prognosis between CEA, CA19-9 positive group and negative group in stage III and IV. On the other hand in stage I and II, the prognosis of CEA positive group was significantly poorer than that of negative group and so was the prognosis of CA19-9 positive group in stage II. Concerned to lymphatic invasion (ly) and venous invasion (v) in stage I, the ly-positive rates in CEA positive group and CA19-9 positive group were significantly higher than those of negative groups and so was the v-positive rate of CA19-9 positive group. But there was no significant relation in stage II. We think that preopeartive CEA and CA19-9 levels might be useful prognostic factors of gastric cancer in a low-grade stage.