title: Evaluation of tumour markers as differential diagnostic tool in patients with suspicion of liver metastases from breast cancer.
abstract: OBJECTIVE
  The liver is the site of breast cancer metastasis in 50% of patients with advanced disease. Tumour markers have been demonstrated as being useful in follow-up of patients with breast cancer, in early detection of recurrence of breast cancer after radical surgical treatments, and in assessing oncologic therapy effect, but no study has been carried out on their usefullness in distinguishing benign liver lesions from breast cancer metastases. The aim of this study was therefore to evaluate the importance of tumour markers carcinoembryonic antigen (CEA), carbohydrate antigen CA19-9 (CA19-9), thymidine kinase (TK), tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and cytokeratin 19 fragment (CYFRA 21-1) in differential diagnosis between benign liver lesions and liver metastases of breast cancer.
  
  
  METHODS
  The study includes 3 groups: 22 patients with liver metastases of breast cancer; 39 patients with benign liver lesions (hemangioma, focal nodular hyperplasia, liver cyst, hepatocellular adenoma); and 21 patients without any liver disease or lesion that were operated on for benign extrahepatic diseases (groin hernia, varices of lower limbs) as a control group. The serum levels of tumour markers were assessed by means of immunoanalytical methods.
  
  
  RESULTS
  Preoperative serum levels of CYFRA 21-1, TPA, TPS and CEA were significantly higher in patients with liver metastases of breast cancer in contrast to healthy controls and patients with benign liver lesions (p-value<0.05). Serum levels of CA19-9 and TK were higher in patients with malignancy in comparison with benign liver disease and healthy controls but these differences were not statistically significant.
  
  
  CONCLUSIONS
  Tumour markers CEA, CYFRA 21-1, TPA and TPS can be recommended as a good tool for differential diagnosis between liver metastases of breast cancer and benign liver lesions.
authors.affiliation: Department of Surgery, Charles University Prague, Pilsen, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Liska
authors.forename: Lubos
authors.initials: L
authors.lastname: Holubec
authors.forename: Vladislav
authors.initials: V
authors.lastname: Treska
authors.forename: Jindra
authors.initials: J
authors.lastname: Vrzalova
authors.forename: Tomas
authors.initials: T
authors.lastname: Skalicky
authors.forename: Alan
authors.initials: A
authors.lastname: Sutnar
authors.forename: Stanislav
authors.initials: S
authors.lastname: Kormunda
authors.forename: Jan
authors.initials: J
authors.lastname: Bruha
authors.forename: Ondrej
authors.initials: O
authors.lastname: Vycital
authors.forename: Jindrich
authors.initials: J
authors.lastname: Finek
authors.forename: Martin
authors.initials: M
authors.lastname: Pesta
authors.forename: Ladislav
authors.initials: L
authors.lastname: Pecen
authors.forename: Ondrej
authors.initials: O
authors.lastname: Topolcan
mesh_terms: D000951:Antigens, Neoplasm / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D001940:Breast / Q000378:metabolism; D001943:Breast Neoplasms / Q000097:blood / Q000175:diagnosis*; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000556:secondary; D011379:Prognosis; D012189:Retrospective Studies; D013937:Thymidine Kinase / Q000097:blood; D019396:Tissue Polypeptide Antigen / Q000097:blood
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D019396:Tissue Polypeptide Antigen; C102012:antigen CYFRA21.1; D013937:Thymidine Kinase