THE DIAGNOSTIC-VALUE OF CA-27-29, CA-15-3, MUCIN-LIKE CARCINOMA ANTIGEN, CARCINOEMBRYONIC ANTIGEN AND CA-19-9 IN BREAST AND GASTROINTESTINAL MALIGNANCIES

In the past decade, considerable interest has arisen for defining the role of various tumor markers in the diagnosis of cancer. This cross-s ectional study evaluates four breast cancer markers (CA 27-29, CA 15-3 , MCA and CEA) and two gastrointestinal (GI) markers (CA 19-9 and CEA) in 213 patients. Receiver operating curves (ROC) revealed a sensitivi ty for the 90% specificity cutoff for breast cancers compared to breas t benign diseases of 70% for CA 27-29, 67.5% for CA 15-3, 52.5% for MC A and 40% for CEA. When GI tumors were compared to benign GI disease, the sensitivity for 90% specificity was 40.3% for CEA and 32.3% for CA 19-9. Comparison of breast cancer and GI malignancies with other mali gnancies leads to a marked shift of the ROC curve to the right and los s of specificity. Late stage for all breast and GI tumor markers was f ound to be a predictor of high serum antigen level (p < 0.001). The pr esence of liver metastases in breast cancer was associated with abnorm al levels of CA 27-29 (p = 0.028). Pancreas adenocarcinomas had a high er CA 19-9 antigen level (p < 0.001) than other GI malignancies. CA 27 -29 appears to be at least as sensitive and specific as CA 15-3 in pat ients with breast cancer. None of the above markers retain their speci ficity when compared with a control group consisting of other malignan cies.