Clinical utility of tumour marker velocity of cancer antigen 15–3 (CA 15–3) and carcinoembryonic antigen (CEA) in breast cancer surveillance

Hing, J.X.; Mok, Chi Wei; Tan, Pei Ting; Sudhakar, S; Seah, Chin Mui; Lee, W.P.; Tan, Su-Ming

doi:10.1016/j.breast.2020.05.005

Cited by 48 publications

(32 citation statements)

References 18 publications

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“…Tumour marker velocity may be a useful adjunct to absolute tumour marker values to distinguish between clinically significant elevated tumour markers from baseline variation. This suggests the clinical utility of serial CA 15-3 and CEA measurements in breast cancer surveillance [ 33 , 34 ]. Serum tumour markers such as CA 15-3 and CEA are still the most widely used serum tumour markers for surveillance purposes and treatment response in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Plasma Concentrations of Matrilysins MMP-7 and MMP-26 as Diagnostic Biomarkers in Breast Cancer

Piskór

Przylipiak

Dąbrowska

et al. 2021

JCM

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Metalloproteinases (MMPs) are a group of proteolytic enzymes involved in the maintenance of a proper structure of extracellular matrix (ECM). Matrilysins (MMP-7 and MMP-26) are members of the MMPs group that show promise as potential breast cancer (BC) markers. The aim of the study was to evaluate plasma levels of MMP-7, MMP-26 and CA 15-3 individually and in combination and assess the diagnostic utility of studied matrilysins in patients with BC. The study group consisted of 120 patients with BC, and the control group consisted of 40 subjects with benign breast cancer and 40 healthy women. Concentrations of MMP-7 and MMP-26 were determined by enzyme-linked immunosorbent assay, and CA 15-3 by chemiluminescent microparticle immunoassay. Plasma levels of MMP-7 were significantly higher in the BC group than in the control group. Concentrations of MMP-26 and CA 15-3 were highest in stages II and IV of the disease. The highest diagnostic sensitivity was observed in stages III and IV BC for the combination of all tested markers (92.5%). The highest diagnostic specificity was noted for all tested parameters combined in the BC group (95.0%). The area under the receiver operating characteristic (ROC) curve (AUC) for the combination of markers (MMP-7+MMP-26+CA 15-3) was the largest (0.9138) in stages III and IV. Individual marker analysis showed that MMP-7 had the highest AUC (0.8894) in advanced stages of the disease. Study results indicate that MMP-7 could be used as an additional marker that would improve the diagnostic utility of CA 15-3 in early stages of BC. Therefore, the combined assessment of MMP-7 and MMP-26 with CA 15-3 might be useful in determining disease progression. Further studies are needed to evaluate whether matrilysins show promise as potential markers for improving the diagnosis of BC.

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Section: Discussionmentioning

confidence: 99%

Plasma Concentrations of Matrilysins MMP-7 and MMP-26 as Diagnostic Biomarkers in Breast Cancer

Piskór

Przylipiak

Dąbrowska

et al. 2021

JCM

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“…A study on detection of breast cancer metastasis showed that combined detection of CA15-3 and CEA increased the sensitivity which proved that combined detection is more useful than single detection 32 . Again, it is reported that while CEA has a higher sensitivity of 75%, CA 15–3 has a higher specificity of 97%, the two tumor markers are complementary to each other, thus the combination of the two markers yielded a higher diagnostic accuracy 19 . However, it is worth noting that while the combined detection improves the sensitivity, the specificity decreases slightly.…”

Section: Discussionmentioning

confidence: 99%

“…It is reported that human breast cancer are characterized by a higher SF level, when compared with normal tissue 18 . However, these tumor markers for the detection of mammary gland tumor shows limited diagnostic sensitivity and specificity 14 , 19 . The detection of the combination of multiple specific tumor markers to improve the diagnosis of canine malignant mammary gland tumor specificity, sensitivity is of great importance in clinical diagnosis 20 .…”

Section: Introductionmentioning

confidence: 99%

Combined detection of CA15-3, CEA, and SF in serum and tissue of canine mammary gland tumor patients

Fan

Ren

Liu

et al. 2021

Sci Rep

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The purpose of this study is to evaluate the levels and clinical diagnosis value of CA15-3, CEA, and SF in canine mammary gland tumors (CMGTs). In this study, the levels of tissues/serum CA15-3, CEA, and SF in 178 CMGT patients or healthy dogs were determined by ELISA and qRT-PCR assay. CA15-3, CEA, and SF levels of the malignant tumor group were significantly higher than that of the benign tumor group and the healthy control group. In the malignant tumor group, CA15-3 held a sensitivity of 51.8%, a specificity of 93.9%, and an accuracy of 76.8%. The sensitivity, specificity, and accuracy of CEA were 44.6%, 84.1%, and 68.1% respectively. SF held a sensitivity of 62.5%, a specificity of 85.4%, and an accuracy of 76.1%. SF showed the highest sensitivity and CA15-3 showed the highest specificity. The sensitivity, specificity, and accuracy of the combined detection of the three biomarkers in malignant tumor groups were 80.4%, 78.0%, and 80.0%, respectively, therefore combined detection increased sensitivity and accuracy but decreased specificity. In conclusion, the combined detection of serum/tissue markers CA15-3, CEA, and SF may improve the detection sensitivity of CMGTs, providing reference value for clinical application.

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“…In a recent study, circulating levels of CA 15–3/MUC1 in patients with newly diagnosed but unresected breast cancer were statistically significantly correlated with metabolic tumor volume and tumor lesion glucose on FDG-PET , providing evidence that CA 15–3 levels can reflect tumor burden ( 20 ). Additionally, in a case-control study that was nested in a cohort of patients who had undergone treatment for operable breast cancer, increases of more than 2.5 U/mL of CA 15–3 during 12 months were statistically significant predictors of recurrence ( P = .01) ( 21 ). This velocity is similar to the change of 1.18 U/mL during 6 months we observed (extrapolating to 2.36 U/mL during 12 months), and it suggests that even small changes in CA 15–3 during a short period of time have the potential to be clinically important.…”

Section: Discussionmentioning

confidence: 99%

Cancer Antigen 15-3/Mucin 1 Levels in CCTG MA.32: A Breast Cancer Randomized Trial of Metformin vs Placebo

Goodwin

Dowling

Ennis

et al. 2021

JNCI Cancer Spectrum

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Background Circulating levels of CA 15–3, a tumor marker and regulator of cellular metabolism, were reduced by metformin in a non-randomized neoadjuvant study. We examine effects of metformin (vs placebo) on CA 15–3 in participants of MA.32, a Phase 3 randomized trial in early-stage breast cancer. Methods 3649 subjects with T1-3, N0-3, M0 breast cancer were randomized; pretreatment and 6 month on-treatment fasting plasma was centrally assayed for CA 15–3. Genomic DNA was analyzed for the rs11212617 single nucleotide polymorphism (SNP). Absolute and relative change of CA 15–3 (metformin versus placebo) were compared using Wilcoxon rank and t-tests. Regression models adjusted for baseline differences and assessed key interactions. All statistical tests were 2-sided. Results Mean (SD) age was 52.4 (10.0) years. The majority had T2/3, node positive, hormone receptor positive, HER2 negative breast cancer treated with (neo)adjuvant chemotherapy and hormone therapy. Mean (SD) baseline CA 15–3 was 17.7 (7.6) and 18.0 (8.1 U/ml). At 6 months, CA 15–3 was statistically significantly reduced in metformin vs placebo arms (absolute geometric mean reduction in CA 15–3 = 7.7% vs 2.0%, P < .001; relative metformin: placebo level of CA 15–3 [adjusted for age, baseline body mass index, and baseline CA 15–3] = 0.94, 95% confidence interval = 0.92 to 0.96). This reduction was independent of tumor characteristics, perioperative systemic therapy, baseline body mass index, insulin and the SNP status (all P ≥0.11). Conclusions Our observation that metformin reduces CA 15–3 by approximately 6% was corroborated in a large placebo-controlled randomized trial. The clinical implications of this reduction in CA 15–3 will be explored in upcoming efficacy analyses of breast cancer outcomes in MA.32.

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Clinical utility of tumour marker velocity of cancer antigen 15–3 (CA 15–3) and carcinoembryonic antigen (CEA) in breast cancer surveillance

Cited by 48 publications

References 18 publications

Plasma Concentrations of Matrilysins MMP-7 and MMP-26 as Diagnostic Biomarkers in Breast Cancer

Plasma Concentrations of Matrilysins MMP-7 and MMP-26 as Diagnostic Biomarkers in Breast Cancer

Combined detection of CA15-3, CEA, and SF in serum and tissue of canine mammary gland tumor patients

Cancer Antigen 15-3/Mucin 1 Levels in CCTG MA.32: A Breast Cancer Randomized Trial of Metformin vs Placebo

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