Study of some tumor markers and their use in breast cancer relapse

Tissue polypeptide antigen [TPA], cancer antigen 15-3 [CA15.3] and carcinoembryonic antigen[CEA] were evaluated by ELISA in 61 patients of breast cancer to evaluate their role in breast cancer relapse, as well as 16 apparently healthy age matched females as control group. The patients were divided into: Post operative group [26 patients] and relapse group [35 patients], eight patients with local recurrent breast cancer and 27 patients with distant metastasis at different sites. Statistically significant elevation was found for the three tested markers in the relapse group compared to the control and post operative group [P < 0.001], also a statistically significant elevation was found in CEA, CA15.3 and TPA in metastatic group compared to local recurrence group [P = 0.01, 0.03 and 0.01 respectively]. TPA level was statistically higher in grade III than in grade II [P = 0.0009]. In relapse group, right sided tumor showed statistically significant elevation of CEA, TPA than the left sided tumor [P = 0.005 and 0.03 respectively]. According to TNM staging CEA showed statistically significant correlation between Ml and Mo [P = 0.01]. In relapse group CA15.3 showed a statistically significant difference between tumor sized > 2 cm and tumor < 2cm [P = 0.04]. In the relapse group there was a statistically significant correlation between multiple lesions and solitary lesions [P = 0.02]. Among the same group there was a significant positive correlation between the percentage of L.N positivity and each of CEA, CA15.3 and TPA. [r - 0.04, 0.42 and 0.51] [P - 0.03, 0.02 and 0.003 respectively]. Another positive correlation was found between tumor size and L.N positivity [r = 0.44] [p = 0.01]. In both post - operative and relapse group there were positive correlations between CA15.3 and CEA [r - 0.45 and 0.56] [P = 0.02 and 0.001 respectively] Positive correlations were found similarly between TPA and CEA [r - 0.50] [P - 0.003] and CA15.3 and TPA [r - 0.57] [P<0.001] in relapse group. Evaluation of tumor markers, separately showed acceptable accuracy profiles regarding the relapse and distant metastatic patients, with CEA being the most sensitive marker, followed by CA15.3 and lastly TPA. In relapse group the most useful combinations for diagnosis could be [CEA and CA15.3] double combination and [CEA, CA15.3 and TPA] triple combination. In distant metastasis group, the combination of choice could be [CEA and TPA] or [CEA and CA15.3] double combinations and CEA, CA15.3 and TPA] triple combination. The use of the 3 markers merit is to be tried in greater number of breast cancer patients

Tumor marker profile in breast cancer patients

Serum TMs CA 15.3, CEA, AFP and TK were studied preoperatively in 30 female patients with invasive duct carcinoma of the breast, presenting to NCI. Eighteen of the patients were in stage II and 6 were in each of stages III and IV. Tissue CEA was estimated in 20 patients and 24 patients were followed up. CEA, AFP and TK were significantly higher in serum of patients group. Nevertheless, most of the patients had CEA and AFP levels within the reference range and neither was considered useful in diagnosing breast cancer. CA 15.3 was elevated in 27.8% stage II patients, in all stage III and 66.6% stage IV patients. Elevated CA 15.3 levels at diagnosis in stage II patients helped to predict metastases. The study may consider CA 15.3 useful in diagnosing advanced breast cancer and in predicting metastases in stage II disease. Tissue CEA levels were positive in 60% of cases and no correlation was observed between tissue and serum CEA level. Eight out of 12 tissue CEA positive cases [66.6%] were associated with node metastases. TK was elevated in 75% stage II patients and 83.3% stage III and IV patients and this elevation is indicative of increased tissue activity