التطبيق السريري للواصمين الورميين CEA و CA 15-3 في المناطرة و تقييم الاستجابة للمعالجة الكيميائية في مريضات سرطان الثّدي النقيلي

الملخص EN

Background: The international health authorities have updated their recommendations and guidelines concerning the uses of tumor markers in clinical oncology without adapting clear standards for their applications in evaluating response evaluation and survival in metastatic breast cancer (MBC).

Objective: to investigate the prognostic indication of two tumor markers; the Carcinoembryonic Antigen (CEA) and Cancer Antigen (CA 15-3) in MBC patients and to assess the correlation between their values' and the response to chemotherapy.

Methods: we conducted a prospective clinical study in a sample of metastatic breast cancer patients undergoing palliative chemotherapy at AlBaironi hospital between August 2011 and January 2014.

Serum concentrations of CEA and CA 15-3 were measured at baseline and after the 3rd and 6th cycles of chemotherapy with carboplatin and vinorelbine.

Changes in the markers’ levels in relevance to clinical response were assessed according to the Response Evaluation Criteria in Solid Tumor (RECIST).

Survival was determined over an 18-month follow-up period.

Statistical analysis was performed using GraphPad Prism® software.

Results: After the 6th cycle, the concentrations of both markers dropped in patients with responsive disease, and to the contrary, they increased in patients with stable disease, however statistical significance was limited to changes of CA 15-3.

Elevated baseline concentrations of CA 15-3 decreased by ≥30% in 50% and 72.7% of responsive patients after the 3rd and 6th cycles respectively.

On the other hand, elevated baseline concentrations of CEA decreased by ≥30% in 72.7% of responsive patients after both cycles.

High basal concentrations of both markers (high/high) predicted an average 12-month survival, whereas the average survival exceeded 18 months for patients with normal basal levels of both markers (normal/normal).

Nevertheless, the correlation of elevated baseline concentrations of both markers with declined survival was not statistically significant.

Conclusions: CA 15-3 and CEA might be useful for monitoring response and follow up in MBC patients; however, they are not reliable as significant prognostic tools in MBC patients..