Article Abstract

Elevated serum carcinoembryonic antigen and CA15-3 levels and the risk of site-specific metastases in metastatic breast cancer

Authors: Zhen-Yu He, Xun Li, Qing-Shuang Chen, Jia-Yuan Sun, Feng-Yan Li, San-Gang Wu, Huan-Xin Lin

Abstract

Background: To assess the relationship between serum carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels and the risk of site-specific metastases in metastatic breast cancer.
Methods: Clinicopathological characteristics of patients diagnosed with metastatic breast cancer at two academic centers between 1998 and 2013 were retrospectively analyzed. The association between serum CEA and CA15-3 levels at systemic recurrence and site-specific metastases was investigated by univariate and multivariate analyzes.
Results: A total of 305 patients were identified. One hundred and thirteen (37.0%) and 139 (45.6%) patients showed elevated serum CEA and CA15-3 levels, respectively. Serum CEA levels were less frequently elevated in patients with triple negative disease (P=0.030). Furthermore, elevated serum CEA (P=0.002) and CA15-3 (P<0.001) levels were significantly correlated with the number of metastatic organ sites. In multivariate analysis, abdomen/pelvis metastases [odds ratio (OR) 2.436; 95% confidence interval (CI), 1.446–4.104, P=0.001] and bone metastases (OR 2.414; 95% CI, 1.399–4.316, P=0.002) showed a strong correlation with elevated serum CEA levels. Elevated serum CA15-3 levels were significantly correlated with pleura metastases (OR 2.368; 95% CI, 1.093–5.133, P=0.029). Abnormal serum CA15-3 levels were a marginally predictive factor for bone metastases (OR 1.688; 95% CI, 0.992–2.874, P=0.054). Elevation of CEA and CA15-3 level was not significant association with the other sites of distant recurrence including lung/mediastina, axillary and/or neck lymph nodes, and other distant soft tissue.
Conclusions: Elevated serum CEA and CA15-3 levels may cause an increased risk of site-specific metastases in metastatic breast cancer. Further studies examining the role of serum CEA and CA15-3 levels in the organ-specific metastatic cascade are required.