Prognostic Impact of Elevation of Cancer Antigen 15-3 (CA15-3) in Patients With Early Breast Cancer With Normal Serum CA15-3 Level.

IF 2.2 4区医学 Q3 ONCOLOGY Journal of Breast Cancer Pub Date : 2023-04-01 DOI:10.4048/jbc.2023.26.e17

Jai Min Ryu, Danbee Kang, Juhee Cho, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam, Se Kyung Lee, Yeon Jin Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim, Hyunjong Lee, Mira Kang, Jong Han Yu

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引用次数: 1

Abstract

Purpose: Cancer antigen 15-3 (CA15-3) is a serum tumor marker for breast cancer (BC) extensively used in clinical practice. CA15-3 is non-invasive, easily available, and a cost-effective tumor marker for immediate diagnosis, monitoring and prediction of BC recurrence. We hypothesized that an elevation of CA15-3 may have prognostic impact in patients with early BC with normal serum CA15-3 level.

Methods: This was a retrospective cohort study, which included patients with BC who received curative surgery at a comprehensive single institution between 2000 and 2016. CA15-3 levels from 0 to 30 U/mL were considered normal, and patients who had CA15-3 > 30 U/mL, were excluded from the study.

Results: The mean age of study participants (n = 11,452) was 49.3 years. The proportion of participants with elevated CA15-3 ≥ 1 standard deviation (SD) compared with the previous examination during follow-up was 23.3% (n = 2,666). During the follow-up (median follow-up 5.8 years), 790 patients experienced recurrence. The fully-adjusted hazard ratio (HR) for recurrence comparing participants with stable CA15-3 level to subjects with elevated CA15-3 level was 1.76 (95% confidence interval [CI], 1.52-2.03). In addition, if the CA15-3 was elevated ≥ 1 SD, the risk was much higher (HR, 6.87; 95% CI, 5.81-8.11) than in patients without elevated CA15-3 ≥ 1 SD. In sensitivity analysis, the recurrence risk was consistently higher in participants with elevated CA15-3 levels than in participants without elevated CA15-3 levels. The association between elevated CA15-3 levels and incidence of recurrence was observed in all subtypes and the association was stronger in patients with N+ than in patients with N0 stage (p-value for interaction < 0.01).

Conclusion: The results of the present study demonstrated that elevation of CA15-3 in patients with early BC and initial normal serum CA15-3 levels has a prognostic impact.

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血清CA15-3水平正常的早期乳腺癌患者癌抗原15-3 (CA15-3)升高对预后的影响

目的:癌抗原15-3 (Cancer antigen 15-3, CA15-3)是临床广泛使用的乳腺癌血清肿瘤标志物。CA15-3是非侵入性的，容易获得的，是一种经济有效的肿瘤标志物，可用于即时诊断、监测和预测BC复发。我们假设CA15-3水平升高可能对血清CA15-3水平正常的早期BC患者的预后有影响。方法:这是一项回顾性队列研究，纳入了2000年至2016年在综合单一机构接受根治性手术的BC患者。CA15-3水平在0 ~ 30 U/mL之间被认为是正常的，CA15-3 > 30 U/mL的患者被排除在研究之外。结果:研究参与者的平均年龄(n = 11452)为49.3岁。随访期间CA15-3≥1标准差(SD)升高的受试者比例为23.3% (n = 2,666)。在随访期间(中位随访5.8年)，790例患者出现复发。CA15-3水平稳定的受试者与CA15-3水平升高的受试者的完全校正风险比(HR)为1.76(95%可信区间[CI]， 1.52-2.03)。此外，如果CA15-3升高≥1 SD，则风险要高得多(HR, 6.87;95% CI, 5.81-8.11)高于CA15-3≥1 SD升高的患者。在敏感性分析中，CA15-3水平升高的患者的复发风险始终高于CA15-3水平未升高的患者。CA15-3水平升高与复发的相关性在所有亚型中均存在，且N+期患者的相关性强于N0期患者(相互作用的p值< 0.01)。结论:本研究结果表明，CA15-3在早期BC患者和初始正常血清CA15-3水平升高具有预后影响。

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来源期刊

Journal of Breast Cancer 医学-肿瘤学

CiteScore

3.80

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Breast Cancer (abbreviated as ''J Breast Cancer'') is the official journal of the Korean Breast Cancer Society, which is issued quarterly in the last day of March, June, September, and December each year since 1998. All the contents of the Journal is available online at the official journal website (http://ejbc.kr) under open access policy. The journal aims to provide a forum for the academic communication between medical doctors, basic science researchers, and health care professionals to be interested in breast cancer. To get this aim, we publish original investigations, review articles, brief communications including case reports, editorial opinions on the topics of importance to breast cancer, and welcome new research findings and epidemiological studies, especially when they contain a regional data to grab the international reader''s interest. Although the journal is mainly dealing with the issues of breast cancer, rare cases among benign breast diseases or evidence-based scientifically written articles providing useful information for clinical practice can be published as well.