Avaliação comparativa de dosagem do marcador tumoral CA 15-3 em cadelas hígidas ou com neoplasia mamária / Comparative evaluation of tumor marker CA 15-3 dosage in dogs, healthy or with breast cancer

O antígeno CA 15-3 é uma proteína presente no soro utilizado no acompanhamento de mulheres com câncer de mama, essencialmente na detecção de metástases. Os objetivos deste estudo foram avaliar a efetividade e a viabilidade da utilização do marcador tumoral CA 15-3 em cadelas, comparando-se os valores do marcador entre cadelas sem e com neoplasia mamária, avaliando-se alterações nos valores do marcador após a mastectomia, e suas correlações entre o tipo histológico. Foi realizada a quantificação sérica do marcador tumoral CA 15-3 (teste de eletroquimioluminescência), em vinte cadelas hígidas (grupo controle) e vinte cadelas com neoplasia mamária (grupo teste). Os animais com neoplasia tiveram a dosagem do marcador realizada antes e 10 dias após a mastectomia. Ainda, foi realiza a citologia vaginal no momento da mastectomia e foram estabelecidos três grupos de acordo com a fase estral de cada cadela, Diestro, Proestro e Anestro. As massas tumorais foram encaminhadas para exame histopatológico. A avaliação dos dados de citologia vaginal entre os grupos Diestro, Proestro e Anestro pelo teste de ANOVA não demonstrou diferença estatística significativa entre os valores encontrados. E na análise para a comparação dos valores do marcador tumoral com os tipos histológicos de neoplasias, divididas em dois grupos, benignas e malignas, utilizando o teste de Mann-Whitney Rank Sum Test, o teste não demonstrou diferença estatística significativa visto que p>0,05. Os valores encontrados do marcador no grupo controle foram uma média de 0,19+0,39 U/mL, no grupo pré-mastectomia 1,56+0,39 U/mL e pós-mastectomia 0,66+0,27 U/mL. Em análise estatística com a comparação de grupo pré e pós-mastectomia, e do grupo controle com o grupo pré e pós-mastectomia observou-se significância com p< 0,005. Assim, observou-se diferença nos valores do marcador antes e depois da remoção cirúrgica da neoplasia, sugerindo seu possível uso como controle de crescimento tumoral pós-mastectomia individual. Porém há muita variação dos resultados nos diferentes métodos existentes, e não há ainda um padrão dos valores de referência para cada método, sendo necessários mais estudos sobre o uso dos marcadores.(AU)

The CA 15-3 antigen is a protein present in the serum, used to monitor women with breast cancer, mainly in metastatic disease detection. The objective of this study was to evaluate the effectiveness and feasibility of the CA 15-3 tumor marker in dogs, comparing the marker values between dogs with or without breast cancer, to estimate changes in marker values after mastectomy, and their correlation between the histological types. Serum quantification of the tumor marker CA 15-3 (electrochemiluminescence test) was performed in twenty healthy bitches and twenty others with mammary neoplasia. Bitches with cancer had the content of the tracer performed before and 10 days after mastectomy. The vaginal cytology was performed at the moment of the mastectomy, dividing the animals into three different groups (diestrus, proestrus and anestrus). All the mammary tumors were examined histopathologically. The evaluation of the vaginal cytology data of the groups Diestro, Proestro and Anestro by the ANOVA test did not show a statistically significant difference between the values ​​found. In the analysis histological types of tumor marker values of neoplasms, divided into two groups, benign and malignant, using the Mann-Whitney Rank Sum Test, there was no statistical significant difference at p>0.05. The values of the marker in the control group had an average of 0.19+0.39 U/mL, of the pre-mastectomy group 1.56+0.39 U/mL, and of the post-mastectomy group 0.66+0.27 U/mL. The statistic was performed comparing groups pre- and post-mastectomy, and the control group with group pre- and post-mastectomy with a statistical significance p< 0.005 in both tests. There was a difference of marker values ​​before and after surgical removal of the neoplasia, suggesting its possible use in post-mastectomy tumor control. But exist variation of results with the different existing methods, and there will be still a standard reference value for each method.(AU)

Effect of MRI combined with serum levels of CA153, CEA and CYFRA21-1 on the diagnostic efficacy of breast cancer patients / 中国医师杂志

Objective To investigate the effect of color magnetic resonance imaging (MRI) combined with serum levels of carbohydrate antigen 153 (CA153),carcinoembryonic antigen (CEA) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) on the diagnostic efficacy of breast cancer patients.Methods From December 2015 to December 2017,80 cases of breast cancer in our hospital were selected as the observation group.Another 98 patients with benign breast diseases as control group A,and 94 healthy women as control group B.The serum levels of CA153,CEA and CYFRA21-1in the three groups were measured by electrochemiluminescence and the level of the above serum indexes in patients with different disease stages (stage Ⅰ to Ⅱ,Ⅲ to Ⅳ) in the observation group were compared.The 3 groups were examined by color Doppler high frequency ultrasound.The specificity,sensitivity and accuracy of color Doppler ultrasound combined with serum CA153,CEA and CYFRA21-1 or detecting alone in the diagnosis of breast cancer analyzed.Results There were significant differences in the levels of serum CA153,CEA and CYFRA21-1 in the 3 groups (P ＜0.05),and the level of serum CA153,CEA and CYFRA21-1 in the observation group was higher than that in the control group A and the control group B (P ＜ 0.05).The levels of serum CA153,CEA and CYFRA21-1 in patients in stage Ⅲ to Ⅳ of the observation group were higher than those in patients in stage Ⅰ to Ⅱ (P ＜ 0.05).The sensitivity and accuracy of color Doppler ultrasound combined with serum CA153,CEA and CYFRA21-1 in the diagnosis of breast cancer were 96.25％ (77/80) and 84.93％ (231/272),respectively,which were all higher than those of serum CA153,CEA and CYFRA21-1 alone (P ＜ 0.05).And the sensitivity of combined diagnosis was higher than that of color Doppler high frequency ultrasound alone (P ＜ 0.05).Conclusions Color Doppler ultrasound combined with serum levels of CA153,CEA and CYFRA21-1 can significantly improve the sensitivity and accuracy of breast cancer diagnosis,reduce the risk of missed diagnosis,and provide a strong basis for diagnosis and treatment of breast cancer.

The evaluation value analysis of serum CEA and CA15-3 levels in breast cancer on chemotherapy curative prognosis evaluation / 国际检验医学杂志

Objective To investigate the value of serum CEA and CA15-3 in the evaluation of breast cancer chemotherapy and prognosis.Methods 63 breast cancer patients were retrospectively analyzed from May 2011 to June 2012 in our Hospitals as breast cancer group,according to the situation of survival would be divided into survival group(n=42) and death group(n=21) and select indicators for outpatient medical normal crowd 63 cases as normal group.Serum levels of CEA and CA15-3 were measured by fluorescence immunoassay for 4 years.The prognosis of all patients was analyzed statistically.Results Serum level of CEA and CA15-3 in Ⅳ period breast cancer patients was obviously higher than Ⅲ period,the difference was statistically significant(P＜ 0.05).Chemotherapy efficient of CEA,CA15-3,CEA and CA15-3 express in negative group were obviously higher than positive group,the difference was statistically significant(P＜0.05).All patients were followed up for 1 to 4 years with an average follow-up time of 3.63 years and 42 patients survived for more than 4 years.CEA positive group patients of 4 years survival rate(55.26％) was obviously lower than negative group(84.00 ％),the difference was statistically significant(P＜0.05).CA15-3positive group patients of 5 years survival rate(52.78％) was obviously lower than negative group(85.19 ％),the difference was statistically significant(P＜ 0.05).CEA and CA15-3 positive group patients of 5 years survival rate (52.38％) was obviously lower than negative group (95.24％),the difference was statistically significant (P ＜ 0.05).Before treatment the serum CEA and CA15-3 level Survival groups was lower than death group,the difference was statistically significant(P＜0.05).Conclusion Detection of serum CEA and CA15-3 levels in patients with breast cancer before chemotherapy can provide reference data for chemotherapy efficacy and prognosis evaluation.Detection of breast cancer patients with chemotherapy before serum CEA and CA15-3 levels can provide reference for chemotherapy curative effect and prognosis assessment data.

The evaluation value analysis of serum CEA and CA15-3 levels in breast cancer on chemotherapy curative prognosis evaluation / 国际检验医学杂志

Objective To investigate the value of serum CEA and CA15-3 in the evaluation of breast cancer chemotherapy and prognosis.Methods 63 breast cancer patients were retrospectively analyzed from May 2011 to June 2012 in our Hospitals as breast cancer group,according to the situation of survival would be divided into survival group(n=42) and death group(n=21) and select indicators for outpatient medical normal crowd 63 cases as normal group.Serum levels of CEA and CA15-3 were measured by fluorescence immunoassay for 4 years.The prognosis of all patients was analyzed statistically.Results Serum level of CEA and CA15-3 in Ⅳ period breast cancer patients was obviously higher than Ⅲ period,the difference was statistically significant(P＜ 0.05).Chemotherapy efficient of CEA,CA15-3,CEA and CA15-3 express in negative group were obviously higher than positive group,the difference was statistically significant(P＜0.05).All patients were followed up for 1 to 4 years with an average follow-up time of 3.63 years and 42 patients survived for more than 4 years.CEA positive group patients of 4 years survival rate(55.26％) was obviously lower than negative group(84.00 ％),the difference was statistically significant(P＜0.05).CA15-3positive group patients of 5 years survival rate(52.78％) was obviously lower than negative group(85.19 ％),the difference was statistically significant(P＜ 0.05).CEA and CA15-3 positive group patients of 5 years survival rate (52.38％) was obviously lower than negative group (95.24％),the difference was statistically significant (P ＜ 0.05).Before treatment the serum CEA and CA15-3 level Survival groups was lower than death group,the difference was statistically significant(P＜0.05).Conclusion Detection of serum CEA and CA15-3 levels in patients with breast cancer before chemotherapy can provide reference data for chemotherapy efficacy and prognosis evaluation.Detection of breast cancer patients with chemotherapy before serum CEA and CA15-3 levels can provide reference for chemotherapy curative effect and prognosis assessment data.

Cáncer de mama en una paciente de 21 años / Breast cancer in a 21 years patient

Se presenta el caso clínico de una paciente de 21 años de edad, quien acudió a la consulta de Oncología del Hospital Gubernamental de Mbabane en Suazilandia por presentar un nódulo en la mama derecha con manifestaciones de dolor intenso desde hacía 1 mes. Fue remitida a la consulta de Cirugía donde le realizaron una biopsia con aguja gruesa, cuyo resultado indicó la presencia de un carcinoma ductal invasivo, clasificado en estadio IIIB al realizar los exámenes complementarios necesarios. La paciente fue trasladada a Sudáfrica para recibir quimioterapia neoadyuvante, con la cual obtuvo mejoría evolutiva clínica y humoral, evidenciada por la reducción del tumor y las cifras del marcador tumoral CA 15-3.

The case report of a 21 years patient who went to the Oncology service in the Government Hospital of Mbabane in Suaziland is presented. She had a nodule in her right breast with manifestations of acute pain for a month. She was referred to the Surgery service where she underwent a core-needle biopsy whose result indicated the presence of a ductal invasive carcinoma, classified in IIIB stage when carrying out the necessary complementary tests. The patient was transferred to South Africa to receive neoadyuvant chemotherapy, with which clinical and humoral response was obtained which was evidenced by tumor reduction and the values of the tumoral marker CA 15-3.

Effect of Acupuncture on ER and PR Expressions in Rats with DMBA-induced Mammary Cancer / 上海针灸杂志

Objective To investigate the effect of acupuncture at Zusanli, Sanyinjiao and Danzhong on mammary estrogen receptor (ER) and progesterone receptor (PR) expressions in rats with dimethylbenzanthracine (DMBA)-induced mammary cancer. Methods One hundred and twenty female SD rats aged 6-8 weeks were randomized into a model group of 60 rats and a blank group of 30 rats. The model group received an oral gavage of DMBA for model making. The blank group received an oral gavage of equal volume of sesame oil. At 15 weeks after model making, the model group of rats was randomized into treatment and control groups. The treatment group received acupuncture at Zusanli, Sanyinjiao and Danzhong, and the control and blank groups, only the same grasp and release. After the completion of acupuncture treatment (twenty-seventh week), abdominal venous blood was taken and serum tumor markers were determined by electrochemiluminescence immunoassay. Tumor masses were counted and their shapes were recorded. The mass was taken and its height, maximum diameter and vertical diameter were measured using a 1 mm precision vernier caliper. Pathological changes in tumor tissues, and ER and PR positive areas and mean optical densities were observed under an Olympus optical microscope.Results There were statistically significant post-treatment differences in the average number and volume of mammary tumors between the treatment group and the control or blank group (P<0.01,P<0.05) and between the control and blank groups (P<0.01). There were statistically significant post-treatment differences in the concentrations of various tumor markers (CA724, CA125, CA199, AEP, CA15-3, CEA and CA50) between the treatment or control group and the blank group (P<0.01,P<0.05) and between the control and blank groups (P<0.01). There was a statistically significant post-treatment difference in CA15-3 concentration between the treatment and control groups (P<0.01). There were statistically significant post-treatment differences in ER and PR positive areas and mean optical densities between the treatment group and the control or blank group (P<0.01) and between the control and blank groups (P<0.01).Conclusions Acupuncture can reduce the occurrence of rat DMBA-induced mammary tumor (including the number and volumes of the tumors). The mechanism of its action may be related to decreasing the concentrations of tumor markers CA724, CA125, CA199, CA15-3, AEP, CEA and CA50 and especially to decreasing CA15-3 concentration, and ER and PR positive areas and mean optical densities.

The relationship of tumor marker and CD4+T cells before and after radiotherapy on patients / 国际检验医学杂志

Objective The study is aimed to research into the effect of CD4+ T cells on patients with severe advanced breast cancer under radiotherapy that cannot be treated with surgery ,by observing the variation of CEA ,AFP ,CA125 and CA15‐3 before and after the radiotherapy applied .Methods We identified the CEA ,AFP ,CA125 and CA15‐3 densities in blood serum for a group of 38 patients with advanced breast cancer and a group of 30 normal people with chemiluminescence immune assay ,and we deter‐mined the CD3+ ,CD4+ ,CD8+ T percentage in peripheral blood and the ratio of CD4+ /CD8+ with flow cytometry .Results The group with normal CD4+ T percentage went through a decreased in CEA ,AFP ,CA125 ,CA15‐3 densities after the radiotherapy ,and the variation was significant(P<0 .05) .The group of people with abnormal CD4+ T percentage go through CEA ,CA15‐3 densities decrease after the radiotherapy ,and the variation was statistically significant(P< 0 .05) .Conclusion For those with advanced breast cancer and cannot be treated with surgery ,the influence of radiotherapy on CEA ,AFP ,CA125 ,CA15‐3 densities is significant in the group of patients with CD4+ T percentage ,adn has better therapeutic effect .

Expressions of CA19-9, CA15-3 and CA125 and their significance in papillary thyroid carcinoma / 天津医药

Objective To investigate the expressions of carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 15-3(CA15-3) and carbohydrate antigen 125(CA125) and their clinical significance in papillary thyroid carcinoma (PTC). Methods The expressions of CA19-9, CA15-3 and CA125 were detected by immunohistochemical MaxVision method in 80 cases of PTC and 80 cases of benign thyroid lesions (BTL), including 34 cases of nodular goiter, 26 cases of Hashimoto's thyroiditis and 20 cases of follicular adenoma. The relationship between expressions of CA19-9, CA15-3 and CA125 and the clinical pathological characteristics were analyzed. Results The expression rates of CA19-9, CA15-3 and CA125 in 80 cases of PTC were 85%, 100%and 43.8%respectively, compared with BTL, the difference was statistically significant (P 0.05). The sensitivity of CA19-9, CA15-3 and CA125 in the differential diagnosis of PTC and BTL were 85%, 100% and 43.8% respectively, and the specificity were 91.3%, 36.3%and 91.3%, respectively. Conclusion The expressions of CA19-9, CA153 and CA125 are helpful for the differential diagnosis of PTC and BTL.

Serum levels of carcino-embryonic antigen and CA15-3 in patients with early stage breast cancer ;before surgery and their correlation with pathological features / 肿瘤研究与临床

Objective To detect and analyze the levels of preoperative serum carcino-embryonic antigen (CEA) and CA15-3 in early invasive breast cancer patients and their correlation with pathological parameters. Methods Electrochemical luminescence immunoassay (ECLI) technology was used to detect serum levels of CEA and CA15-3 in 223 cases of early invasive breast cancer patients, 109 patients with benign lesions, and 30 cases of heath control. Immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) were used to detect the estrogen receptors (ER), progesterone recepter (PR), and its HER-2 pathological indicators.Besides, the correlation of serum CA15-3, CEA levels and pathological parameters was analyzed. Results The serum CA15-3 and CEA levels of Breast cancer patients [(22.27±15.11) U/ml, (5.03± 0.49) μg/L] were significantly higher than that of patients in benign lesion group [(14.13±3.04) U/ml, (2.72± 0.11) μg/L] (P0.05). CEA positive rate of breast cancer group was significantly higher than that of benign lesions(13.5%vs. 3.7%, 26.5%vs. 1.8%, P<0.05). 30 cases of normal control group had no positive one. The joint monitoring sensitivity of CEA and CA15-3 breast cancer group was 9.4 %, the sensitivity was 0 in benign lesion group. There was significant difference (P < 0.05). Conclusion The changes of Serum CA15-3 and CEA levels in breast cancer patients can be considered as the judgment standard for early diagnosis, pathological staging, prognosis and clinical effect monitoring.

Plasma Levels and Diagnostic Utility of Macrophage Colony-Stimulating Factor, Matrix Metalloproteinase-9, and Tissue Inhibitor of Metalloproteinases-1 as New Biomarkers of Breast Cancer

BACKGROUND: Macrophage colony-stimulating factor (M-CSF), matrix metalloproteinase-9 (MMP-9), and its specific tissue inhibitor - tissue inhibitor of metalloproteinases-1 (TIMP-1) may play an important role in the pathogenesis and spread of cancer. We investigated the plasma levels of M-CSF, MMP-9, and TIMP-1 in comparison with a commonly accepted tumor marker CA 15-3 in breast cancer patients and in control groups. METHODS: The cohort included 110 breast cancer patients in groups at stages I-IV. The control group consisted of 50 healthy volunteers and 50 benign tumor patients. Plasma levels of M-CSF, MMP-9, and TIMP-1 were determined by using ELISA, while CA 15-3 concentrations were determined by using chemiluminescent microparticle immunoassay (CMIA). RESULTS: The results showed significant differences in concentrations of the analyzed parameters and in levels of CA 15-3 between the groups of breast cancer patients and the two control groups. Diagnosis using these markers was equal to that using CA 15-3 in terms of sensitivity, predictive values of positive and negativetest results (PPV, NPV) and area under the ROC curve (AUC) in the studied groups. The diagnostic specificities of MMP-9, TIMP-1, M-CSF, and CA 15-3 showed equally high values (95%). The combined use of all tested parameters with CA 15-3 resulted in increased sensitivity, NPV, and AUC, especially in the combination of M-CSF with tumor markers (76%, 64%, and 0.8653). CONCLUSIONS: These findings suggest the tested parameters are useful in the diagnosis of breast cancer patients (except stage I), when combined with CA 15-3.

Clinical significance of serum CA15-3 as a prognostic parameter during follow-up periods in patients with breast cancer

PURPOSE: To assess the relationship between the kinetics of the serum CA15-3 level and the five-year disease-free survival rate of breast cancer patients. METHODS: The subjects of this study, 297 women who were diagnosed with breast cancer, were the subset of patients operated on at Kosin University Gospel Hospital from January 2008 to December 2010. We evaluated the change of serum CA15-3 levels during outpatient follow-up period. The changing patterns of serum CA15-3 level were divided into 5 categories; surge without decline, surge with incidental decline, decline without surge, decline with incidental surge, and no change. Clinicopathologic factors were evaluated for each group. RESULTS: The number of patients in surge without decline, surge with incidental decline, decline without surge, decline with incidental surge, and no changes groups were 30 (10.1%), 85 (28.6%), 80 (26.9%), 73 (24.6%), and 29 (9.7%), respectively. The clinicopathologic characteristics were not significantly different among these groups. The log rank test found that 5-year disease-free survival rate according to the kinetics of serum CA15-3 levels were significant (P = 0.004) particularly for the surge without decline group. CONCLUSION: According to the findings of this study, the surge without incidental decline pattern of serum CA15-3 levels during the follow-up period is associated with poor prognosis. Significant association was found among changing patterns of serum CA15-3 levels and breast cancer recurrence rate.

Clinical application value of combined detection of Hcy,FA,VitB12 and CA15-3 in breast cancer patients / 中国免疫学杂志

Objective:To evaluate the alternation of homocysteine (Hcy),folic acid(FA),CA15-3 and vitaminB12(VitB12) in patients with breast cancer and explore the correlation of them.Methods:The levels of FA ,CA15-3 and VitB12 in serum of 55 breast cancer and 35 benign tumor of breast and 50 controls were measured by electro-chemiluminescence immunoassay ( ECLI ) , the Hcy levels were measured by colorimetric method.Results:Compared with the normal controls and benign tumor of breast cancer ,there were some significantly changes in breast cancer patients including Hcy ,CA15-3 increased and FA ,VitB12 reduced ( P＜0.05 ) ,there were no significant differences in Hcy,FA,CA15-3,VitB12 levels between benign breast tumors and normal controls (P>0.05).Companied with TNM stage increased ,the levels of FA breast cancer groups decreased ,the levels of Hcy,CA15-3 increased.The correlation analysis showed that Hcy was negatively correlated with FA and VitB 12,(r=-0.341,r=-0.540),CA15-3 was negatively correlated with FA, CA15-3 was postively correlated with Hcy (r=0.378,r=-0.361).Conclusion: Serum Hcy,CA15-3,FA and VitB12 detection in patients with breast cancer are helpful in the severity judgment and regimen prognosis .

The clinical value of liquid tumor biomarker detection for breast cancer / 中国癌症杂志

Circulating tumor markers have been paid more attention in the application of the treatment for breast cancer, the level of which has extended from protein to gene, including traditional tumor markers, HER-2 extracellular domain, circulating tumor cells, circulating tumor DNA (ctDNA), circulating RNA (ctRNA) and so on. As “liquid detection”, the detection of circulating tumor markers with real-time dynamic, easy operation, good reproducibility and other advantages are widely used in aiding early diagnosis, determining prognosis, prospectively predicting response or resistance to speciifc therapies, surveillance after primary surgery, and monitoring therapy in patients with advanced disease, The further study of circulating tumor markers may contribute to patient’s individual treatment.

Correlation between serum CA15-3 level and the molecular subtypes of metastatic breast cancer / 肿瘤

Objective: To retrospectively analyze the correlation between serum CA15-3 level and the molecular subtypes of metastatic breast cancer. Methods: A total of 268 patients diagnosed as having metastatic breast cancer in Hubei Cancer Hospital were recruited in this study. The serum CA15-3 level was examined by immunoradiometric assay, and the expression levels of ER (estrogen receptor), PR (progesterone receptor) and HER-2 (human epidermal growth factor receptor-2) were detected by immunohistochemistry and FISH (fluorescence in situ hybridization). The 268 patients were classified into 3 groups according to hormone receptor status: luminal subtype (ER-positive irrespective of HER-2-positive/negative and PR-positive/negative), HER-2 over-expression subtype (ER-negative/PR-negative/HER-2-positive) and basal-like subtype (ER-negative/PR-negative/HER-2-negative). The serum CA15-3 level and its elevation among freguency three subtypes of metastatic breast cancer were compared. Results: The average level of CA15-3 was significantly different among the three subtypes. The average level of CA15-3 in luminal subtype (96 U/mL) was significantly higher than those in HER-2 overexpression subtype (52 U/mL) and basal-like subtype (72 U/mL) (P = 0.017). The frequency of elevation of serum CA15-3 level in patients with luminal subtype (80.8%) was much higher than those in patients with HER-2 over-expression subtype (55.6%) and basal-like subtype (68.6%) (P = 0.002). Compared to other metastasis, the mean level of CA15-3 and the incidence of CA15-3 elevation were higher in patients with bone metastasis (P < 0.05). Conclusion: The serum CA15-3 level in patients with luminal subtype of metastatic breast cancer is obviously increased, and the frequency of elevation of serum CA15-3 level is also significantly higher. It is suggested that the detection of serum CA15-3 is more valuable in the surveillance of recurrence and metastasis luminal subtype of ER-positive of breast cancer. Copyright © 2012 by TUMOR.

Metástasis óseas múltiples de cáncer de mama: papel del CA 15.3 y respuesta a la hormonoterapia / Bone metastasis of breast carcinoma: role of tumoral marker CA 15.3 and hormonal therapy response

Las metástasis óseas suponen el 65-75 por ciento de casos de cáncer de mama avanzado. Los marcadores tumorales (CA 15.3, CEA) son útiles en el seguimiento de las pacientes y en la valoración de la respuesta al tratamiento. En el cáncer de mama metastásico de bajo grado, el tratamiento hormonal es la opción terapéutica más acertada debido a la baja toxicidad y alta probabilidad de respuesta generalmente de larga duración a la que se asocia. Se presenta el caso de una paciente con cáncer de mama tratado con cirugía, quimioterapia y radioterapia, asintomática durante el seguimiento y en la que metástasis óseas múltiples son detectadas a partir de una elevación del marcador CA 15.3. La hormonoterapia es el tratamiento pautado inicialmente con buena respuesta y tolerancia. Dicho tratamiento logra estabilizar las lesiones óseas durante 7 años y es precisamente al suspenderlo cuando aparecen nuevas lesiones también a nivel óseo detectadas de nuevo ante un incremento del marcador CA 15.3. La terapia hormonal pautada de nuevo vuelve a conseguir estabilizar las lesiones.

Bone metastases are involved in a 65-75 percent of advanced metastatic breast cancer cases. Tumoral markers (CEA, CA 15.3) are useful in the follow-up and evaluation of response to treatment. Hormonal therapy is the optimal treatment option in low grade metastatic breast cancer due to low toxicity and general long term good response. We present a breast cancer case treated with surgery, chemotherapy and radiotherapy. The patient was asymptomatic during the follow-up and multiple bone metastases were diagnosed as a result of an increased CA 15.3 marker found. Hormone therapy was the recommended initial treatment with good response and tolerance. Bone lesions remained stabilized for 7 years but after treatment suspension new bone lesions appeared. CA 15.3 marker had increased again. Reintroduction of hormonal therapy achieved again the stabilization of the lesions.

Evaluation of the UniCel(TM) DxI 800 Immunoassay Analyzer in Measuring Five Tumor Markers

PURPOSE: Tumor marker concentrations in a given specimen measured by different analyzers vary according to assay methods, epitopes for antibodies used, and reagent specificities. Although great effort in quality assessment has been instituted, discrepancies among results from different analyzers are still present. We evaluated the assay performance of the UniCel(TM) DxI 800 automated analyzer in measuring the alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125, CA 15-3 and CA 19-9 tumor markers. MATERIALS AND METHODS: The linearity and precision performance of the five tumor marker assays were evaluated, and concentrations of the respective markers as measured by DxI were compared to those measured by other conventional analyzers (ADVIA Centaur(TM) and Vitros(TM) ECi) using 200 specimens collected from 100 healthy persons and 100 patients with respective cancers. RESULTS: The linear fits for all five tumor markers were statistically acceptable (F=4648 for AFP, F=15846 for CEA, F=6445 for CA 125, F=2285 for CA 15-3, F=7459 for CA 19-9; p<0.0001 for all). The imprecision of each tumor marker assay was less than 5% coefficient of variation, except for low and high concentrations of AFP. The results from UniCel(TM) DxI 800 were highly correlated with those from other analyzers. CONCLUSION: Our results demonstrate that UniCel(TM) DxI 800 has good linearity and precision performance for the tumor markers assayed in this study. However, there were discrepancies between assaying methods. Efforts to standardize tumor marker assays should be undertaken, and the redetermination of cut-off levels is necessary when developing methods of analyzing tumor markers.

Inhibitory effects of recombinant bacillus Calmette-Guérin vaccines coexpressing tandem repeats of MUC1 and GM-CSF on the growth of breast cancer / 中华普通外科杂志

Objective To construct a recombinant bacillus Calmette-Guérin(BCG) vaccines based on different tandem repeats of MUC1 and GM-CSF, rBCG-MVNTR1/4/8-CSF, and to observe the ability of three recombinant BCG vaccines in the inhibition of breast cancer. Methods After MUC1 variable-number tandem repeats (MVNTR1/4/8) were cloned in a stepwise manner, the E. coli-Mycobacteria shuttle expression vector pDE22-MVNTR1/4/8-CSF were constructed by fusing MVNTR1/4/8 and GM-CSF, and then used to transform competent BCG by electroporation after identification by restriction endonuclease digestion analysis and DNA sequencing. A novel breast cancer vaccines, rBCG-MVNTR1/4/8-CSF was constructed. The expression of fused MVNTR1/4/8-CSF protiens was analyzed by SDS-PAGE and Western blot. The ability of rBCG vaccines inhibiting the growth of breast cancer was observed in hu-PBL-SCID mice. The specific T cell responses in mice were assessed by immunohistochemistry. Results The expression of recombinant MVNTR1/4/8-CSF fusion proteins were detected by SDS-PAGE and Western Blot in rBCG-MVNTR1/4/8-CSF vaccines, respectively. Tumor incidence in mice prophylactic immunized with rBCG-MVNTR4-CSF (37.5%) or rBCG-MVNTR8-CSF (25%) significantly decreased compared with PBS and BCG-pDE22 control ( 100% ) at 42 days after tumor implantation ( P ＜ 0. 05 ). MCF-7 tumor growth inhibition in rBCG- MVNTR4/8-CSF-immunized mice was more significant than that in controls ( P ＜0. 01 ).The inhibition effect of three rBCG vaccines on breast rumor growth appeared to rise with increase of numbers of the tandem repeats of MUC1. Survival rate was 75% of mice in the rBCG-MVNTR4-CSF-treated group and 87. 5% of mice in the rBCG-MVNTR8-CSF-treated groups at 70 days after tumor implantation; however,survival rate was only 12. 5% in control group( P ＜0. 05). The CD4-positive and CD8-positive lymphocytes were detected only in rBCG-MVNTR4/8-CSF-immunized mice. Conclusions rBCG-MVNTR4/8-CSF immunization inhibits breast cancer growth in mice.

The associated investigation between overexpressed MUC-1mRNA and the pathogenesis of lung adenocarcinoma / 中国医师杂志

Objective To explore the preliminary significance of overexpressed MUC-1 mRNA in the pathogenesis of lung adenocarcinoma. Method Total RNAs of 23 paired fresh lung samples and lung adenocarcinoma samples were extracted by routine Trizol way. After total RNAs were transcribed into cDNA, the expression of MUC-1 gene was detected in these samples by real-time PCR. Finally, the correlation of MUC-1 expression with the pathogenesis of lung adenocarcinoma was analyzed. Result Compared with normal lung tissues, the expression of MUC-1 in 20( 87% ) lung adenocarcinoma samples was markedly increased. Compared with early and mid-stage lung adenocarcinoma samples,. the overexpressed MUC-1 in late stage lung adenocarcinoma samples was increased by 2.2 folds. In addition, compared with primary lung adenocarcinoma samples without lymph node metastasis, MUC-1 mRNA was increased in primary lung adenocarcinoma samples with lymph node and distant metastasis ( 2.5 folds). Conclusion Overexpressed MUC-1 may participate in the pathogenesis of lung adenocarcinoma.

Utilidad clínica de los marcadores tumorales / Clinical utility of tumor markers

Los marcadores tumorales, también denominados marcadores biológicos o biomarcadores, se definen como moléculas, sustancias o procesos que se alteran cualitativa o cuantitativamente como resultado de una condición precancerosa o un cáncer, detectables mediante una prueba de laboratorio en sangre, en líquidos orgánicos o en tejidos. La naturaleza de los marcadores tumorales es muy variable: va desde ácido nucleico, ADN o ARN, una proteína o un péptido, hasta procesos complejos como un anticuerpo, la apoptosis, la amilogénesis y la proliferación. Desde el punto de vista de su origen, los marcadores tumorales se producen por el tumor mismo, como la gonadotropina coriónica en el coriocarcinoma, o como respuesta a la lesión tumoral en el tejido circundante, como el antígeno carcinoembrionario en el cáncer de mama. No hay un marcador tumoral ideal, definido como aquel con una sensibilidad y especificidad del 100. Los marcadores tumorales pueden ser utilizados para el cribado en población con riesgo de presentar un cáncer para su detección precoz con enfermedad confinada y potencialmente curable, como parte del diagnóstico, en el diagnóstico diferencial, como prueba de valor pronóstico y predictivo, como herramienta para evaluar el tratamiento administrado, y para la detección de las recaídas cuando éstas se presentan y el paciente tiene una nueva oportunidad de tratamiento, antes de que las manifestaciones clínicas reaparezcan. En este módulo se analizan los principales marcadores tumorales disponibles en el medio, como el antígeno carcinoembrionario, la alfafetoproteína, el antígeno específico de próstata, el CA 15-3, el CA 125, el CA 19-9, el Cyfra 21-1, la gonadotropina coriónica, la calcitonina, la ferritina, la beta 2 microglobulina, entre otros marcadores. Además, se hará referencia a marcadores subrogados de cáncer, como la presencia de la infección por Helicobacter pylori y el virus del papiloma humano.

Diagnostic value of tumor markers assays in benign and malignant pleural effusions / 肿瘤研究与临床

Objective To evaluate the diagnostic value of four common pleural fluid tumor markers.Methods A total of 126 patients (52 with definite malignant effusions, and 74 with benign effusions) were enrolled. Tumor markers [carcinoembryonic antigen (CEA), cancer antigen 125(CA125), carbohydrate antigen 15-3 (CA 15-3) and cytokeratin 19 fragments (CYFRA21-1)] in pleural fluid were determined by electrochemiluminescence immunoassay. The sensitivities, specificities, accuracies and youden index(YI) of single and combination of those markers were calculated. Results Malignant pleural effusions had higher levels of pleural fluid markers than effusions due to benign conditions. CA125 had the highest sensitivity (90.4 %), and CYFRA21-1 had the highest specificity (79.7 %), CEA and CYFRA21-1 had the highest accuracy (71.4 %), CEA had the highest YI (0.41). The combination of several serum tumor markers had higher sensitivities than the single marker for diagnosis of malignant pleural effusion. When the three tumor markers were combined with CEA, the combination of CEA, CYFRA21-1 and CA15-3 yielded the best results,with a sensitivity of 92.3 %, a specificity of 78.4 %, and an accuracy of 84.1%, YI of 0.71, while the combination of four tumor markers had a sensitivity of 94.2 %, a specificity of 75.7 %, and an accuracy of 83.3 %, YI of 0.70, and there was no statistical significance between the two combinations (P ＞0.05).Conclusion Single tumor marker had limited diagnostic value for malignant pleural effusions, while CEA,CYFRA21-1 and CA15-3 yielded the best and the most economic method, that guiding the selection of patients who might benefit from further invasive procedures.