Klinický význam stanovení nádorových markerův průběhu follow up u karcinomu prsu

Clinical Significance of the Follow Up of Tumor Markers in the BreastCarcinoma

Background.
Paper deals with detection of the early disease progression in breast cancer patients during follow upusing tumor markers.Methods and Results. The basic group of 1184 patients with breast carcinoma in follow up after primary therapywere examined from 1996 to 2002. Sera were tested using commercial kits CA 15-3 (MEIA, Abbot), CEA (IRMA,Immunotech), TPA (IRMA, Byk Sangtec), TPS (IRMA, Beki). Results were compared with the retrospectivelyconfirmed clinical status of individual patients. The authors calculated optimal cut offs and sensitivities and theircombinations for particular tumor markers at 95 % level of specificity. Best sensitivities for the detection of distantmetastases into bone, liver, lung and brain was achieved by CA 15-3 (53– 68%). As an optimal combination of tumormarkers seems to be the tricombination CA 15-3, CEA and TPA. All the tumor markers have insufficient sensitivityfor the metastatic process into the lymphnodes.Conclusions. As optimal combination of tumor markers during the follow up seem to be tricombination CA 15-3,CEA and TPA, but also the clinical relevance and cost effectiveness of these assessments have to be considered. Forthe tumor disease follow up only CA 15-3 has sufficient sensitivities (at 95% specificities) for the early diagnosisof the metastatic process.

Key words:
breast carcinoma, tumor markers, metastatic process.