CA15-3, CASA, MSA, and TPS as diagnostic serum markers in breast cancer.
This is the first comparison of the three mucin based tests CA15-3, CASA, and MSA, and the cytokeratin-related TPS assay in breast cancer. The mucin markers were superior to TPS in receiver-operator analysis, though no marker was of use in the diagnosis of malignancy due to low sensitivity. Using cutpoints that gave 95% specificity in benign disease (n = 83), corresponding sensitivities in pre-treatment breast cancer (n = 123: 13 in situ, 54 stage I, 45 stage II, 4 stage III, 7 stage IV) were 17% (CA15-3), 16% (CASA), 13% (MSA), and 8% (TPS), with a strong relationship between marker levels and disease stage. These assays did not always detect the same patients, and the use of CA15-3 combined with CASA gave the highest sensitivity (23%), though this was not significantly better than the use of CA15-3 alone. Despite detecting similar antigens, these assays can show markedly different responses in some patients, indicating that one mucin-based test cannot be substituted for another.
Devine
P L
PL
Dept. Obstetrics & Gynaecology, University of Queensland, St. Lucia, Australia.
Duroux
M A
MA
Quin
R J
RJ
McGuckin
M A
MA
Joy
G J
GJ
Ward
B G
BG
Pollard
C W
CW
D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D018396:Mucin-1 / Q000097:blood*; D009367:Neoplasm Staging; D010455:Peptides / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018396:Mucin-1; D010455:Peptides; C053409:mammary serum antigen, human; C089984:tissue polypeptide specific antigen