Synonyms: Cancer antigen CA 15-3, 15-3 Sancer the Antigen
Scientific editor: M. Merkusheva, PSPbGMU them. Acad. Pavlov, general medicine.
October, 2018.
Overview
Tumor marker CA 15-3 - is an important diagnostic indicator for determining breast cancer in women and men. The relevance of the study is quite high, because in the last decade the incidence of the disease has increased by almost a third.
Analysis of CA15-3 should be performed dynamically. This approach provides the most complete picture of the clinical course of disease, stage form and the likelihood of cancer metastasis. The apparent advantage of this study is that an increase in the concentration of tumor marker CA 15-3 in the blood can stay ahead of the primary symptoms of the disease for 6-9 months. This allows for early and timely diagnosis of cancer process.
CA15-3 - a glycoprotein which is produced by the tissues of the breast. It can also be contained in the epithelium of the respiratory tract, the uterus. When the tumor marker of malignant cells in the blood level starts to rise. Increasing the CA15-3 values recorded in 10% of patients with primary oncology and 70% of patients with metastases (secondary processing). That is not sensitive tumor markers and indicators for early diagnosis of cancer if it is already apparent symptoms. But the study are useful for assessing the changes in the dynamics of indicators for monitoring response to treatment of breast cancer and recurrence of the disease.
Most highly specific test for the parser 15-3 has with respect to the mammary carcinoma - up to 95%. In some cases, an increase in the blood component can be observed in other malignant processes (E.g., cancer of the intestine), as well as non-cancerous diseases nature (fibroadenoma, inflammation of the bile ducts).
Tumor marker CA 15-3 normally can be elevated in pregnant women (up to 40 IU / L), due to physiological changes in a woman's body (rapid proliferation of breast tissue). Excess estrogen that occurs in expectant mothers, creates favorable conditions for the emergence of benign and malignant cells. During lactation hormone level is reduced, which reduces the likelihood of breast cancer.
In men, breast oncology is quite rare, and the reason for this usually are serious hormonal disorders in puberty, and / or male menopause.
CA 15-3 test allows you to set the type and stage of cancer, the exact place of its location, as well as to trace the dynamics of remission after effective treatment. However, a definitive diagnosis oncologist has the right to deliver only after additional research: Cytology tissues and blood test for carcinoembryonic antigen (CEA).
CA15-3 was elevated in all patients with proven distant metastases and 35.5% of patients with metastasis to regional lymph nodes1.
Indications for analysis
The test for a cancer antigen CA 15-3 among professionals is considered a subsidiary and is assigned to the following purposes:
- confirmation or refutation malignancy in mammary glands;
- differential diagnosis of benign and malignant tumors, mastopathy, other inflammatory or infectious processes mammary glands and organs;
- assessment of the dynamics of operational efficiency or conservative treatment of confirmed breast cancer;
- estimate of the probability of metastasis and recurrence;
- , predict the course of disease, remission, control patients rehabilitation;
- obtaining data on the form and volume of the tumor, its localization and the extent of (the greater proportion of CA 15-3 in the plasma, the greater the amount of malignant cells develop breast tissue glands).
On the necessity of the appointment of this test as part of a comprehensive study of mammary glands may suggest the following clinical signs:
- emergence cones, seals or other structures in the breast tissue, as determined visually or during palpation;
- pain in the chest, feeling of fullness or heaviness;
- abnormal discharge from the nipple (including the representatives of the male sex);
- change in shape of the nipple (retracted, roughness, redness), occurrence for cracks or wounds which may bleed;
- change the structure of tissues and skin (redness, generalized edema, roughness, the effect of "lemon peel");
- immobility breast (the tumor has grown into the sternum, which leads to muscle strain and glands);
- inflammation of the regional lymph nodes, their increase.
Learn more about the methodology of self-breast in women can be found in our a separate article.
The study also used in patients at risk for cancer:
- the presence of relatives of direct line, a history was diagnosed with cancer of the internal organs;
- age over 40-50 years;
- continuous hormonal support, oral contraceptives, hormone replacement therapy;
- chronically elevated levels of estrogen in the blood;
- chronic disorders of the menstrual cycle, secondary amenorrhea;
- before the beginning of menstruation;
- late menopause;
- ovarian cancer history.
The interpretation of the test results on the cancer antigen CA 15-3 spend oncologist mammolog surgeon or functional diagnostician.
reference values
Important! Norms vary depending on the reagents and equipment used in a particular laboratory. Therefore, when interpreting the results it is necessary to use standards adopted precisely in the lab where to be tested. It is also necessary to pay attention to the units.
The following are the most commonly used ranges:
- less than 31.3 U / ml (Invitro)2
- 0 - 25 U / ml. (Helix)2
- Less than 30 IU / ml (European standard)3
Average rate of 15-3 for the CA is the value of 0-27 U / ml. Alternative unit IU / ml is 0-22 threshold. Specified range indicates the absence of malignancy or its tendency to decrease during successful therapy.
Value of 22 to 30 U / ml is the border, so interpretation of additional research are involved, e.g., CEA or cytology analysis. The higher the level of CA 15-3 in the blood, the greater the likelihood that began the process of metastasis, and tumor itself holds a significant share in the body. At the same time at a high level oncomarker metastases more frequently found in the tissues of the liver and bones.
Excess norm more than 40 U / ml is critical and suggests oncology mammary glands.
Elevated CA 15-3
Assume the growth of cancer antigen CA 15-3 values in pregnant patients (in the third trimester may reach 40-50 units / ml) and during lactation.
Also, a moderate increase in rate up to 50 IU / ml can be observed in benign processes:
- Inflammation of the gallbladder and bile ducts;
- Benign mammary processes (cysts, Adenomas, polyps);
- endometriosis;
- Inflammatory liver diseases (hepatitis, cirrhosis, failure, granulomatosis and others);
- Pelvic inflammatory disease;
- autoimmune processes (Eg rheumatic diseases, sarcoidosis, and others, systemic lupus erythematosus);
- disease of the breast various etiology;
- Systemic diseases of internal organs;
- Fibroadenoma.
A significant increase can be observed in the following processes:
- breast cancer (Breast carcinoma), especially at later stages in the presence of metastasis;
- Oncology respiratory organs (e.g., bronchogenic carcinoma, lung cancer);
- Cancer other internal organs (less): the pancreas, uterus, colon, ovarian, stomach, liver, uterine cervix;
- Tuberculosis;
- Colorectal cancer.
Higher levels of CA 15-3 are associated with more advanced stages of breast cancer or with a larger tumor burden. If the tumor produces CA 15-3, the level of markers will increase as the tumor growth. The highest levels are metastasis, especially in the liver and bone.
Please be aware that the concentration of CA 15-3 may remain within normal limits in a third of patients with tumors of the breast due to violation of tumor marker production.
Important! Interpretation of the results is always carried out comprehensively. An accurate diagnosis on the basis of only one analysis impossible.
Reducing the level of CA 15-3
The complete absence of CA 15-3 in the blood can indicate the effectiveness of the chosen regimen or on an early stage of the malignant process, when antigen secretion has not yet started.
Training
Analysis of cancer antigen CA 15-3 should be done several times (for the study of the dynamics), namely, through a well-defined time intervals doctor.
The biomaterial for research: serum of venous blood.
method of collecting biological material: the cubital vein venipuncture without a tourniquet.
Mandatory conditions: strictly on an empty stomach in the morning (from 8.00 to 11.00).
Additional requirements:
- 10-12 hour fasting day before the test (3-5 hours can only drink pure non-carbonated water);
- rejection of greasy food, alcohol, tobacco and medication, including vitamins, one day prior to venipuncture;
- respect for the physical and emotional rest for 2-3 days before the procedure and necessarily directly in front of her;
- compliance rest interval (one week) between other therapeutic and diagnostic procedures in the mammary gland (biopsy, massage, palpation) and the moment of the test.
sources:
- 1. Fejzic H. Tumor marker CA 15-3 in breast cancer patients. - Acta medica academica, 2015; 44 (1): 39-46.
- 2. These laboratories Invitro and Helix.
- 3. Nikhil G Thaker, MD. CA 15-3. - Medscape, Sep 05, 2014.
