Evre III-B meme kanserli hastalarda CEA ve CA 15-3 düzeylerinin takipteki önemi

Yıl 2023, Cilt: 14 Sayı: 4, 696 - 702, 30.12.2023

Doğan Öztürk , Süleyman Oral

https://doi.org/10.18663/tjcl.1369602

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

The importance of monitoring of CEA and CA 15-3 levels in patients with stageIII-B breastcancer

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.