CA15-3

同

糖鎖抗原15-3 carbohydrate antigen 15-3

関

腫瘍マーカー

• 進行乳癌/再発乳癌の腫瘍マーカー

PrepTutorEJDIC

1. California

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/09 22:17:41」(JST)

wiki en

[Wiki en表示]

CA15-3 (Cancer Antigen 15-3) is a tumor marker used to monitor certain cancers, especially breast cancer. It is found on the surface of many types of cancer cells and shed into the blood stream. It is used to monitor advanced, i.e. metastatic, cancer.

Elevated CA15-3, in conjunction with alkaline phosphatase (ALP), was found to be associated with an increased chance of early recurrence in breast cancer.

CA15-3 and associated CA27.29 (aka BR27.29) are different epitopes on the same protein antigen product of the breast cancer-associated MUC1 gene. CA27.29 has enhanced sensitivity and specificity and has therefore surpassed CA15-3 as a serum tumor marker. CA27.29 is elevated in 30% of patients with low-stage disease and 60 to 70% of patients with advanced-stage breast cancer.

Both CA27.29 and CA15-3 may be elevated in patients with benign ovarian cysts, benign breast disease, and benign liver disease. Elevations may also be seen in cirrhosis, sarcoidosis and lupus.

CA27.29 levels over 100 U/mL or CA15-3 levels over 25 U/mL are rare in benign conditions.

CA27.29 may be elevated in non-breast malignancies including colon, stomach, pancreas, prostate and lung.

References

See also

• Breast cancer treatment
• carcinoembryonic antigen (CEA), another marker used for cancer

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 乳癌の臨床的特徴、診断および病期分類 clinical features diagnosis and staging of newly diagnosed breast cancer
• 2. 限局性初期乳癌における予後予測因子 prognostic and predictive factors in early non metastatic breast cancer
• 3. 転移性乳癌の全身治療：一般原則 systemic treatment for metastatic breast cancer general principles
• 4. 原発不明癌の分類およびマネージメントの概要 overview of the classification and management of cancers of unknown primary site
• 5. 原発不明の低分化癌 poorly differentiated cancer from an unknown primary site

English Journal

• Novel electrochemical aptamer biosensor based on an enzyme-gold nanoparticle dual label for the ultrasensitive detection of epithelial tumour marker MUC1.

• Hu R, Wen W, Wang Q, Xiong H, Zhang X, Gu H, Wang S.Author information Hubei Collaborative Innovation Center for Advanced Organic Chemical Materials, Ministry of Education Key Laboratory for the Synthesis and Application of Organic Functional Molecules & College of Chemistry and Chemical Engineering, Hubei University, Wuhan 430062, PR China.AbstractA novel platform based on a hairpin oligonucleotide (HO) switch, gold nanoparticles (AuNPs), and enzyme signal amplification for the ultrasensitive detection of mucin 1 protein (MUC1) was developed in this assay. This HO aptamers and horseradish peroxidase (HRP) were immobilised on the AuNPs to yield HO-AuNP-HRP conjugates. AuNPs were used as labels and bridges between the HO and HRP. HRP was also used as label for catalysing the oxidation of o-phenylenediamine by H2O2. The reaction product was 2,3-diaminophenazine (DAP), which was reduced and could be detected at surface of modified electrode. The reduction signal of DAP was used as a probe for the sensitive detection. After the recognition between oligonucleotide and MUC1, biotin was exposed. Biotin, along with the conjugate, was captured by streptavidin onto the surface of modified electrode. Therefore, the detection of target MUC1 which was a membrane-associated glycoprotein of the mucin family could be sensitively transduced via detection of the electrochemical reduction signal of DAP. Compared to other aptasensors, this biosensor has a good linear correlation ranges from 8.8nM to 353.3nM and a lower detection limit of 2.2nM for MUC1. The proposed method provided a new electrochemical approach for the detection of MUC1.
• Biosensors & bioelectronics.Biosens Bioelectron.2014 Mar 15;53:384-9. doi: 10.1016/j.bios.2013.10.015. Epub 2013 Oct 24.
• A novel platform based on a hairpin oligonucleotide (HO) switch, gold nanoparticles (AuNPs), and enzyme signal amplification for the ultrasensitive detection of mucin 1 protein (MUC1) was developed in this assay. This HO aptamers and horseradish peroxidase (HRP) were immobilised on the AuNPs to yiel
• PMID 24189297

• Serum levels of CEA and CA15-3 in different molecular subtypes and prognostic value in Chinese breast cancer.

• Wu SG1, He ZY2, Zhou J3, Sun JY2, Li FY2, Lin Q1, Guo L4, Lin HX5.Author information 1Xiamen Cancer Center, Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.2State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.3Xiamen Cancer Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.4State Key Laboratory of Oncology in Southern China, Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China. Electronic address: hecunzhang@163.com.5State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China. Electronic address: hezhy@sysucc.org.cn.AbstractThe prognostic significance of preoperative carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels in breast cancer is controversial. This study evaluated the prognostic value of preoperative serum CEA and CA15-3 levels in Chinese breast cancer patients. A total of 470 patients with breast cancer had preoperative CEA and CA15-3 concentrations measured. The relationships between preoperative concentration and clinicopathological factors and outcomes were determined. CEA and CA15-3 levels were increased in 34 (7.2%) and 58 (12.3%) patients, respectively. Elevations of serum CEA and CA-15-3 levels correlated with the primary tumor size and axillary lymph node status. CEA levels were lower in patients with triple-negative breast cancer than in those with other subtypes (P = 0.002). The 5-year distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) of CEA-negative vs. CEA-positive patients were 84.1% vs. 54.5% (P < 0.001), 82.7% vs. 54.8% (P < 0.001), and 89.7% vs. 78.5% (P = 0.007), respectively. The 5-year DMFS, DFS, and OS of CA15-3-negative vs. CA15-3-positive patients were 84.0% vs. 69.6% (P = 0.002), 83.0% vs. 66.2% (P < 0.001), 90.9% vs. 74.2% (P = 0.005), respectively. Multivariate analysis of prognosis indicated that CEA and CA15-3 levels were independent prognostic factors for DMFS (P = 0.021) and DFS (P = 0.032), and DFS (P = 0.014) and OS (P = 0.032), respectively. Serum levels of CEA and CA15-3 may differ in breast cancer molecular subtypes and preoperative levels of CEA and CA15-3 have a significant effect on prognosis in Chinese women with breast cancer.
• Breast (Edinburgh, Scotland).Breast.2014 Feb;23(1):88-93. doi: 10.1016/j.breast.2013.11.003. Epub 2013 Dec 2.
• The prognostic significance of preoperative carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels in breast cancer is controversial. This study evaluated the prognostic value of preoperative serum CEA and CA15-3 levels in Chinese breast cancer patients. A total of 470 patients with
• PMID 24291374

• Gold nanoparticle modified capacitive sensor platform for multiple marker detection.

• Altintas Z, Kallempudi SS, Gurbuz Y.Author information Faculty of Engineering and Natural Science, Sabanci University, Orhanli, Tuzla, Istanbul 34956, Turkey.AbstractThe detection and quantification of cancer biomarkers in human blood is crucial to diagnose patients in the early stage of a disease. The recent advances in biosensor technology can improve detection by reducing the application time and cost without an invasive approach. In this study, a highly sensitive, novel nanoparticle-modified capacitive sensor was developed for the detection of cancer markers. The current work mainly focused on developing a surface modification protocol for achieving higher sensitivity using Au-NPs. An interdigitated electrode (IDE) transducer was modified using gold nanoparticles (Au-NPs) for signal enhancement, the platform was initially optimized with a small size IL-6 protein and the methodology was then applied for multiple marker detection with the aim of precise disease diagnostics. Carcinoembryonic antigen (CEA) and epidermal growth factor receptor (hEGFR) could be successfully detected in the concentration range of 20-1000pgmL(-1) while cancer antigen 15-3 (CA15-3) was detected in the range of 10-200UmL(-1). These results show an increase of sensitivity by five-fold with respect to those not modified, demonstrating a highly sensitive and specific capacitive immunoassay that has a great potential for the use of early diagnosis of cancer disease.
• Talanta.Talanta.2014 Jan 15;118:270-6. doi: 10.1016/j.talanta.2013.10.030. Epub 2013 Oct 25.
• The detection and quantification of cancer biomarkers in human blood is crucial to diagnose patients in the early stage of a disease. The recent advances in biosensor technology can improve detection by reducing the application time and cost without an invasive approach. In this study, a highly sens
• PMID 24274298

Japanese Journal

• Could the serial determination of Ca15.3 serum improve the diagnostic accuracy of PET/CT? Results from small population with previous breast cancer

• EVANGELISTA Laura,BARETTA Zora,VINANTE Lorenzo,CERVINO Anna Rita,GREGIANIN Michele,GHIOTTO Cristina,BOZZA Fernando,SALADINI Giorgio
• Annals of nuclear medicine 25(7), 469-477, 2011-08-01
• NAID 10029525489

• 呼吸器内視鏡検査が胸膜・肺転移の診断に有用であった術後15年目の再発乳癌の1例

• 山田 秀哉,福岡 和也,田端 千春,安光 亮洋,政近 江利子,前田 理沙,大桑 久弥,神谷 瞳,本田 実紀,大搗 泰一郎,三上 浩司,野木 佳孝,平山 倫子,寺田 貴普,岡田 あすか,村上 亜紀,田村 邦宣,栗林 康造,中野 孝司
• 気管支学 : 日本気管支研究会雑誌 33(4), 250-255, 2011-07-25
• … 認め当科に紹介となった.胸水検査では原因となる所見は得られなかった.^<18>F-fluorodeoxyglucose positron-emission tomography (^<18>FDG-PET)にて右下葉と頸椎,胸椎などに多発するFDGの集積充進を認め,血清CA15-3 30.9U/mlと高値であり,乳癌の肺転移,骨転移が疑われた.気管支内視鏡にて乳癌肺転移と診断局所麻酔下胸腔鏡では,壁側胸膜に多発結節を認め,生検にて乳癌の胸膜転移と診断した.結論.呼吸器内視鏡検 …
• NAID 110008687251

Related Links

• 腫瘍マーカー CA15-3

CA15-3は早期がんでは陽性を示すことはありませんが、乳がんの再発・転移の判定に 非常に有用な腫瘍マーカーです。

• CA15-3、 乳がんのマーカー

CA15-3、 乳がんのマーカー 腫瘍マーカー. <腫瘍マーカーとは>腫瘍細胞自身が 作り出しているか、腫瘍がからだの中にあることによって作られる物質で、この物質を 測ることにより癌の診断の補助や、病期の予測、経過観察、治療効果の判定などに利用 できる ...

Related Pictures

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★リンクテーブル★

国試過去問	「106A036」
リンク元	「腫瘍マーカー」
関連記事	「CA」

「106A036」

　　[★]

• 48歳の女性。 1か月前からの全身倦怠感を主訴に来院した。 42歳時に右乳癌の治療を受けている。乳癌はエストロゲン受容体陰性、 HER2陰性であった。
• 身長158cm、体重54kg。体温36.4℃。脈拍72/分、整。血圧120/60mmHg。眼球結膜に黄染を認めない。腹部は平坦、軟で、右肋骨弓下に肝の辺縁を触知する。
• 血液所見:赤血球324万、 Hb9.6g/dl、 Ht34%、白血球6,700、血小板36万。血液生化学所見:総蛋白6.8g/dl、アルブミン4.0g/dl、尿素窒素16mg/dl、クレアチニン0.7mg/dl、総ビリルビン0.6mg/dl、 AST68IU/l、 ALT80IU/l。 CA15-3 150U/ml(基準30以下)。腹部造影CT(別冊No. 13)を別に示す。治療として適切なのはどれか。

• a　肝切除術
• b　放射線治療
• c　ホルモン療法
• d　全身抗癌化学療法
• e　分子標的薬(トラスツズマブ)の投与

[正答]

D

※国試ナビ4※　［106A035］←［国試_106］→［106A037］

「腫瘍マーカー」

　　[★]

英

tumor marker

同

生物学的腫瘍マーカー biological tumor marker、癌マーカー cancer marker、悪性腫瘍特異物質 tumor-specific antigen

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肺癌の腫瘍マーカー

	陽性率(疾患があるときに陽性となる確率, 感度)
	肺癌					備考
		扁平上皮癌	腺癌	小細胞癌	その他の疾患
CYFRA21-1	57.5%*	70-80%/73.1%*	30-40%	30-40%	良性疾患:10-15%
SCC		○			子宮頸癌、食道癌、皮膚癌
CEA	40-50%		50-60%
SLX	70%*		0.4		肝硬変
NSE	10-30%			70-90%
proGRP				70-90%/65.1%*		NSEより上昇率が高く、特異性に優れる
KL-6		○			肺腺癌、膵癌、乳癌で40-50%。間質性肺炎の補助診断
無印：標準呼吸器病学 第1版 p.327。* 臨床検査学第32版 p.634

臨床応用されている腫瘍マーカー (LAB.630)

肝癌関連　AFP, AFP-L3%, PIVKA-II
膵癌ならびにその他の消化器癌　CEA, CA19-9, Dupan-2, CA50, Span-1
肺癌　CEA, sialyl Lex-i (SLX), SCC, SYFRA21-1, NSE, ProGRP
婦人科悪性腫痩
　子宮癌：SCC, CA125
　卵巣癌：CA125, AFP, CEA, CA19-9, GAT
　乳癌　：CA15-3, BCA225, CEA, NCC-ST-439
尿器科悪性腫壕
　前立腺痛：PSA(γ-Sm), PAP
　膀胱癌　：BTA, NMP22
　神経内分泌腫療　NSE
　広範な腫瘍に反応するマーカー
　　TPA, BFP, IAP

消化管悪性腫瘍マーカー

• CEA：胎児癌性蛋白。陽性率：(50-70%)大腸癌、胆道癌、膵癌。(40-60%)肺癌。(30-40%)胃癌。良性疾患でも上昇する(胆嚢炎、胆管炎、膵炎)。
• DU-PAN-2：2→3シアリルLec抗原を認識する抗体。陽性率：(70-80%)膵癌、(60-70%)胆道癌。Lea-b-の個体でも陽性になる。良性疾患でも上昇する(慢性肝炎、肝硬変、胆道炎症を伴う胆石症)。
• CA19-9：Leaの基本骨格にシアル酸が結合したもの。陽性率：(80-90%)膵癌。(70-80%)胆道癌。良性疾患でも上昇する((10-40%)閉塞性黄疸、慢性肝炎、肝硬変)。日本人の約7-10%に存在するフコース転移酵素が欠如したLea-b-の個体ではCA19-9は産生されない。
• SLX：Lexの基本骨格にシアル酸が結合したもの。陽性率：(高い)肺癌、卵巣癌。(50-60%)胆道癌、膵癌。

主な腫瘍マーカー CBT QB vol2 p.297

AFP	肝細胞癌、肝芽腫、卵黄脳腫瘍
CEA	消化器系の癌、肺癌、乳癌(腺癌の頻度が高く、臓器特異性は低い)
CA19-9	胆道系の癌、膵癌
CA125	卵巣癌
CA15-3	乳癌、卵巣癌
PIVKA-II	肝細胞癌
PSA	前立腺癌

組織型別に有用な腫瘍マーカー(NEWエッセンシャル産科学・婦人科学 第3版 p.236)

上皮性腫瘍
　漿液性腺癌: CA125 *1
　粘液性腺癌: CA19-9 *2, CA72-4, CEA
胚細胞腫瘍
　卵黄嚢腫瘍: AFP *3
　絨毛癌: hCG
　未分化胚細胞腫: LDH *4
　悪性転化を伴う成熟嚢胞性奇形腫(扁平上皮癌) : SCC
性索間質性腫瘍(ホルモン)
　顆粒膜細胞腫,莢膜細胞腫:工ストロゲン
　Sertoli-間質性腫瘍, Leydig細胞腫(門細胞腫) :テストステロン
*1　上皮性腫瘍中で最も有用.類内膜腺癌,明細胞腺癌でも陽性を示す.子宮内膜症,炎症,妊娠初期も軽度-中等度上昇
*2　成熟嚢胞性奇形腫で陽性を示すことがある
*3　胎芽性癌,混合性腔細胞腫療でも陽性を示す
*4　非特異的

also see →「生殖系チュートリアル症例2_プレゼン.ppt」

産婦人科において重要視される腫瘍マーカー

• CEA：子宮癌、卵巣癌、粘液性卵巣腫瘍

• 大腸粘膜で発現している糖タンパク質

• 癌患者の血清中の他に、胎児の消化管粘膜にも見いだされたことから命名された。
• 補助診断、治療のモニターとして使われる

• 臓器特異性、疾患特異性は高くない。

• 早期癌の診断には役立たない。

• AFP：卵黄嚢腫瘍

• 胎児期に肝臓および卵黄嚢で発現

• 肝細胞癌、肝細胞の再生局面で再び産生されるようになることがある

• 肝細胞癌、卵黄嚢腫瘍、肝芽腫の腫瘍マーカー、炎症性肝疾患における肝再生の指標

• CA19-9：卵巣癌、子宮体癌

• (腫瘍)細胞表面の糖蛋白に結合している糖鎖

• 癌の血行性転移を促進するらしい
• 正常の胆管・膵管上皮、唾液腺でも発現

• 早期癌での陽性率は低い。

• 補助診断、治療・再発のモニター

• CA125：卵巣癌(漿液性嚢胞腺癌、粘液性嚢胞腺癌)、子宮頚癌、子宮体癌

• ヒト培養卵巣癌細胞に見いだされた抗原

• 卵巣癌の腫瘍マーカーとして用いられる(陽性率60-80%)
• 組織型によって陽性率が異なる(漿液性嚢胞腺癌 > 粘液性嚢胞腺癌)

• 診断、治療効果の評価、再発のモニターなどに有用

• SCC

• 子宮頚部扁平上皮癌から精製された蛋白質
• 早期癌でも比較的高い陽性率を示し、経過観察にも有用である。
• 一般に扁平上皮の存在する部位に広範な重症疾患存在すれば血中のSCCは上昇しうる
• 皮膚表面、唾液中に大量に存在し、採血時に複数回穿刺する事などによるコンタミネーションの可能性があります。

• 子宮頚癌(扁平上皮癌)、腟扁平上皮癌、外陰癌

腫瘍マーカー　臓器別

OLM.372改変

(略)

「CA」

　　[★]

• カテコールアミン catecholamine
• 癌 cancer carcinoma
• 炭酸脱水酵素 carbonic anhydrase
• 生活年齢 chronological age
• 糖鎖抗原 carbohydrate antigen