Survival in familial and non-familial breast cancer by age and stage at diagnosis

Soluble POSTN is a novel biomarker complementing CA153 and CEA for breast cancer diagnosis and metastasis prediction

BACKGROUND

Breast cancer (BCa) is the leading cause of cancer deaths among women. Reliable biomarkers for early diagnosis and metastasis prediction are essential to improve the prognosis of BCa. This study aimed to evaluate serum periostin (POSTN) as a novel biomarker complementing CA153 (carbohydrate antigen 153) and CEA (carcinoembryonic antigen) for BCa diagnosis and metastasis prediction.

METHODS

To assess the potential of soluble POSTN as a circulating biomarker, 242 participants, including 173 patients with different stages of BCa and 69 healthy individuals, were enrolled in this study. Soluble POSTN, together with CA153 and CEA, were determined in serum by enzyme linked immunosorbent assay (ELISA) or electrochemiluminescence immunoassays.

RESULTS

Serum POSTN levels in locoregional BCa patients were significantly higher than that in healthy controls. Receiver operating curve (ROC) analysis revealed that, to distinguish health controls from locoregional BCa, POSTN was observed with the highest AUC (area under curve) (AUC_POSTN = 0.72 [0.65 - 0.79], AUC_CA153 = 0.57 [0.49 - 0.64], AUC_CEA = 0.62 [0.55 - 0.69]), and both CA153 and CEA were observed with significantly improved AUCs by combination with POSTN (AUC_{POSTN + CA153} = 0.74 [0.67 - 0.80], P < 0.001; AUC_{POSTN + CEA} = 0.77 [0.70 - 0.82], P < 0.001). Moreover, the performances of the POSTN were comparable with that of CA153 in predicting distant metastasis of BCa (AUC_POSTN = 0.78 [0.71 - 0.84], AUC_CA153 = 0.82 [0.76 - 0.88]). Kaplan-Meier analysis indicated that elevated serum POSTN was associated with poor overall survival and progression-free survival.

CONCLUSIONS

This study suggested that soluble POSTN is a promising potential biomarker for diagnosis and metastasis prediction of BCa.

The association between prognosis of breast cancer and first-degree family history of breast or ovarian cancer: a systematic review and meta-analysis

Whether a positive family history of breast cancer or ovarian cancer (FHBOC) would affect the prognosis of breast cancer is still up for debate and further study. This meta-analysis was performed to clarify this issue. We reviewed two databases (PubMed and CNKI) for research articles published at any time from the inception of these databases to April 1, 2016 for articles detecting the impact of FHBOC on the prognosis of breast cancer. A meta-analysis was conducted to generated combined hazard ratios (HR) with 95% confidence intervals (CI) for overall survival (OS) and breast cancer-specific survival (BCSS). Eighteen studies were included in our qualitative analysis, with 15 studies ultimately part of the quantitative analysis. The pooled results demonstrated that a positive FHBOC was associated with better OS (0.89, 95% CI 0.83-0.95) and BCSS (0.90, 95% CI 0.82-0.99). In subgroup analyses, several subgroups (maximally adjusted studies, population based studies, high quality studies, family history of breast cancer, studies from Europe, studies from Asia, 1 affected relative, or tumor size > 2 cm), a positive first-degree FHBOC was associated with better prognosis of breast cancer. Notably, for those patients who underwent breast-conserving surgery, first-degree FHBOC was not a risk factor for OS (HR 1.08, 95% CI 0.53-2.21). Our meta-analysis demonstrated that a first-degree FHBOC was associated with better OS and BCSS in patients with breast cancer. These findings support that clinical management should not differ between women with and without FHBOC.