Expression And Significance Of Carcinoembryonic Antigen,cancer Antigen 153 And Cyclooxygenase-2 In Breast Cancer

Objective The aim of this study was to evaluate carcinoembryonic antigen(CEA),carbohydrate antigen 153(CA153)in serum and nipple discharge and cyclooxygenase-2(COX-2)in tissue expression in breast cancer and their associations with diagnosis,prognostic evaluation and follow-up of breast cancer.Methods ① Detection of CA153 and CEA in serum and nipple discharge:The serum from 256 patients with breast cancer(as observation group)were collected and the tumor markers of CEA and CA153 were detected with electrochemiluminescence method using the Roche automatic electrochemiluminescence analyzer E-601.Among the 256 cases of breast cancer patient in observation group there were 86 cases presented nipple discharge phenomenon and CA153 and CEA markers in liquid were detected both in serum and nipple discharge.Another 60 patients of usual breast ductal hyperplasia lesions and presented nipple discharge were selected as the control group,and the difference of CA153 and CEA between observation group and control group was analyzed.②Histological COX-2 detection COX-2 was detected using Ultra SensitiveTM S-P immunohistochemical method in breast cancer group(128 cases of invasive ductal carcinoma including the 86 cases of breast carcinoma presented nipple discharge),precancerous lesions group(89 cases of ductal carcinoma in situ and 57 cases of atypical ductal hyperplasia group),and benign breast lesions control group(60 cases of usual breast ductal hyperplasia lesions with nipple discharge).Among 128 cases invasive ductal carcinoma,86 cases had follow-up data.The difference of expression of COX-2 level were analysis in breast cancer group with breast cancer tumor size,age,histological grade,tumor stage,lymph node metastasis,ER,PR,HER2/neu and Ki-67 value index relationship.③ The correlation analyze of CEA and CA153 in serum and nipple discharge,and the level of COX-2 in tissues was performed.Results ①The CEA and CA153 biomarkers levels of serum and nipple discharge in the malignant groups were significantly higher than those in benign groups(P<0.01)and the levels of CA153 and CEA in nipple discharge was significantly higher than those in serum(P<0.01).②The sensitivity of combined detection of nipple discharge fluid and serum was 97.7%,the negative predictive value of nipple discharge and serum was 99.0%.Compared with single index and other combination of comparison,the difference of sensitivity of combined detection of nipple discharge fluid and serum was statistically significant(P<0.05).Univariate analysis showed that the nipple discharge CA153 and CEA levels can be used as a routine indicator of breast cancer and multivariate analysis showed that CA153,CEA in serum and nipple discharge as a variable in the diagnosis of breast cancer can improve the sensitivity,accuracy and negative predictive value.③ The serum levels of CEA and CA153 of breast cancer were significantly higher in high stage group(stage Ⅲ)than that of the low stage group(Ⅰ and Ⅱ),lymph node metastasis group than non metastasis group,tumor recurrence group than non recurrence group(P<0.01).④ Immunohistochemical analysis showed that COX-2 was expressed in only 15.4%(10/60)of normal mammary duct hyperplasia,and its expression intensity was weak,and the positive rates of COX-2 in breast invasive cancer were 78.9%(101/128),which were higher than those in ductal carcinoma in situ(55.1%,49/89),atypical ductal hyperplasia group(42.1%,24/57)and benign lesions control group and there were statistically significant(P<0.05);but there was no significant difference of COX-2 expression between ductal carcinoma in situ group and the atypical ductal hyperplasia group(P>0.05).⑤There was positive correlation in overexpression of COX-2 in breast cancer with histological grade,lymph node metastasis,distant metastasis and recurrence(P<0.05,respectively).However,the expressions of the COX-2 were not related with age and tumor size(respectively,P>0.05).⑥ The nipple discharge biomarker levels of CEA and CA153 in COX-2 positive patients in breast carcinoma were significantly higher than those in negative patients(P<0.05,respectively).Conclusions ①The sensitivity,accuracy and negative predictive value of CA153,CEA in serum and nipple discharge in the diagnosis of breast cancer were significantly higher than those of individual items and other combination detection,and can be used as a routine variate of breast cancer.② The serum and nipple discharge CA153 and CEA levels had positive correlation with COX-2.③ Detection of tissue COX-2 levels and CEA,CA153 both in serum and nipple discharge may guide the evaluation and follow-up of the prognosis of breast cancer patients.