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Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes

BACKGROUND: Although the prognosis for operable breast cancers is reportedly worse if serum carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels are above normal, the usefulness of this prognosis is limited due to the low sensitivity and specificity; in addition, the optimal cutoff...

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Autores principales: Imamura, Michiko, Morimoto, Takashi, Nomura, Takashi, Michishita, Shintaro, Nishimukai, Arisa, Higuchi, Tomoko, Fujimoto, Yukie, Miyagawa, Yoshimasa, Kira, Ayako, Murase, Keiko, Araki, Kazuhiro, Takatsuka, Yuichi, Oh, Koshi, Masai, Yoshikazu, Akazawa, Kouhei, Miyoshi, Yasuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809836/
https://www.ncbi.nlm.nih.gov/pubmed/29433529
http://dx.doi.org/10.1186/s12957-018-1325-6
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author Imamura, Michiko
Morimoto, Takashi
Nomura, Takashi
Michishita, Shintaro
Nishimukai, Arisa
Higuchi, Tomoko
Fujimoto, Yukie
Miyagawa, Yoshimasa
Kira, Ayako
Murase, Keiko
Araki, Kazuhiro
Takatsuka, Yuichi
Oh, Koshi
Masai, Yoshikazu
Akazawa, Kouhei
Miyoshi, Yasuo
author_facet Imamura, Michiko
Morimoto, Takashi
Nomura, Takashi
Michishita, Shintaro
Nishimukai, Arisa
Higuchi, Tomoko
Fujimoto, Yukie
Miyagawa, Yoshimasa
Kira, Ayako
Murase, Keiko
Araki, Kazuhiro
Takatsuka, Yuichi
Oh, Koshi
Masai, Yoshikazu
Akazawa, Kouhei
Miyoshi, Yasuo
author_sort Imamura, Michiko
collection PubMed
description BACKGROUND: Although the prognosis for operable breast cancers is reportedly worse if serum carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels are above normal, the usefulness of this prognosis is limited due to the low sensitivity and specificity; in addition, the optimal cutoff levels remain unknown. METHODS: A total of 1076 patients who were operated for breast cancers (test set = 608, validation set = 468) without evidence of metastasis were recruited, and their baseline and postoperative serum CEA and CA15-3 levels were analyzed. The optimal cutoff values of CEA and CA15-3 for disease-free survival (DFS) were 3.2 ng/mL and 13.3 U/mL, respectively, based on receiver operating characteristic curve and area under the curve analyses. RESULTS: The DFS of patients with high CEA levels (CEA-high: n = 191, 5-year DFS 70.6%) was significantly worse (p < 0.0001) than that of CEA-low patients (n = 885, 5-year DFS 87.2%). There was a significant difference in DFS (p < 0.0001) between CA15-3-high and CA15-3-low patients (n = 314 and n = 762, respectively; 5-year DFS 71.8 vs. 89.3%). Significant associations between DFS and CA15-3 levels were observed irrespective of the subtypes. Multivariable analysis indicated that tumor size, lymph node metastasis, tumor grade, and CEA (p = 0.0474) and CA15-3 (p < 0.0001) levels were independent prognostic factors (hazard ratio [HR] 1.520, 95% confidence interval [CI] 1.005–2.245 for CEA; HR 2.088, 95% CI 1.457–2.901 for CA15-3). CONCLUSIONS: These findings suggest that CEA and CA15-3 levels might be useful for predicting the prognosis of patients with operable early breast cancer irrespective of the subtype. Serum levels at baseline may reflect tumor characteristics for metastatic potential even when these levels are within the normal ranges. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12957-018-1325-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-58098362018-02-16 Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes Imamura, Michiko Morimoto, Takashi Nomura, Takashi Michishita, Shintaro Nishimukai, Arisa Higuchi, Tomoko Fujimoto, Yukie Miyagawa, Yoshimasa Kira, Ayako Murase, Keiko Araki, Kazuhiro Takatsuka, Yuichi Oh, Koshi Masai, Yoshikazu Akazawa, Kouhei Miyoshi, Yasuo World J Surg Oncol Research BACKGROUND: Although the prognosis for operable breast cancers is reportedly worse if serum carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels are above normal, the usefulness of this prognosis is limited due to the low sensitivity and specificity; in addition, the optimal cutoff levels remain unknown. METHODS: A total of 1076 patients who were operated for breast cancers (test set = 608, validation set = 468) without evidence of metastasis were recruited, and their baseline and postoperative serum CEA and CA15-3 levels were analyzed. The optimal cutoff values of CEA and CA15-3 for disease-free survival (DFS) were 3.2 ng/mL and 13.3 U/mL, respectively, based on receiver operating characteristic curve and area under the curve analyses. RESULTS: The DFS of patients with high CEA levels (CEA-high: n = 191, 5-year DFS 70.6%) was significantly worse (p < 0.0001) than that of CEA-low patients (n = 885, 5-year DFS 87.2%). There was a significant difference in DFS (p < 0.0001) between CA15-3-high and CA15-3-low patients (n = 314 and n = 762, respectively; 5-year DFS 71.8 vs. 89.3%). Significant associations between DFS and CA15-3 levels were observed irrespective of the subtypes. Multivariable analysis indicated that tumor size, lymph node metastasis, tumor grade, and CEA (p = 0.0474) and CA15-3 (p < 0.0001) levels were independent prognostic factors (hazard ratio [HR] 1.520, 95% confidence interval [CI] 1.005–2.245 for CEA; HR 2.088, 95% CI 1.457–2.901 for CA15-3). CONCLUSIONS: These findings suggest that CEA and CA15-3 levels might be useful for predicting the prognosis of patients with operable early breast cancer irrespective of the subtype. Serum levels at baseline may reflect tumor characteristics for metastatic potential even when these levels are within the normal ranges. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12957-018-1325-6) contains supplementary material, which is available to authorized users. BioMed Central 2018-02-12 /pmc/articles/PMC5809836/ /pubmed/29433529 http://dx.doi.org/10.1186/s12957-018-1325-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Imamura, Michiko
Morimoto, Takashi
Nomura, Takashi
Michishita, Shintaro
Nishimukai, Arisa
Higuchi, Tomoko
Fujimoto, Yukie
Miyagawa, Yoshimasa
Kira, Ayako
Murase, Keiko
Araki, Kazuhiro
Takatsuka, Yuichi
Oh, Koshi
Masai, Yoshikazu
Akazawa, Kouhei
Miyoshi, Yasuo
Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes
title Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes
title_full Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes
title_fullStr Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes
title_full_unstemmed Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes
title_short Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes
title_sort independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809836/
https://www.ncbi.nlm.nih.gov/pubmed/29433529
http://dx.doi.org/10.1186/s12957-018-1325-6
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