Preoperative Serum Levels of Sialyl Lewisa, Sialyl Lewisx, and Carcinoembryonic Antigens as Prognostic Factors after Resection for Primary Breast Cancer

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Sialyl Lewisa (CA19-9) and sialyl LewisX antigens (CSLEXI) may play a role in tumor metastasis by serving as functional ligands in the cell adhesion system. To determine their prognostic value, we examined preoperative serum levels of CA19-9, CSLEXI, and carcinoembryonic antigen (CEA) in 64 female patients with primary breast cancer who underwent radical mastectomy. The patients were divided into two groups, termed the low- and high-antigen groups based on a value selected as a diagnostic cut-off. Correlation between the serum antigen levels, various established clinicopathologic factors, and prognosis were studied by univariate and multivariate analysis. The high- CEA group was at a more advanced stage (including T factor, N factor, M factor, and Stage) than the low-CEA group. Patients with high serum levels of CEA had shorter disease- specific intervals than those with low serum levels (P <0.0001), whereas disease-specific intervals did not differ between low- and high-CA19-9 or CSLEXI groups. A Cox's regression multivariate analysis revealed a high serum CEA level as an independent factor for worse outcome, separate from Stage. In conclusion, an elevated preoperative serum CEA level was a predictor for poor outcome after radical mastectomy for breast cancer, while CA19-9 and CSLEX1 were not.
長崎大学の論文