Izvorni znanstveni članak
Analysis of tumor marker CA 15-3 and hormone receptor status related to metastatic involvement of interpectoral (Rotter's) lymph nodes
Danko Velimir Vrdoljak
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Vesna Ramljak
; Department of Clinical Cytology, University Hospital for Tumors, Zagreb, Croatia
Dubravka Mužina
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Miroslav Lesar
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Miroslav Banović
; Department of ClinicalTransfusiology, University Hospital for Tumors, Zagreb, Croatia
Andrej Roth
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Gordana Brozović
; Department of Anesthesiology, University Hospital for Tumors, Zagreb, Croatia
Sažetak
The study was aimed at analyzing metastatic involvement in interpectoral (Rotter's) lymph nodes related to tumor marker CA 15-3 and hormone receptor status.
The study includes 172 female patients undergoing surgery for breast cancer at the University Hospital for Tumors, Zagreb, Croatia from November 2001 to August 2003. In addition to the standard surgical procedure, interpectoral (Rotter's) lymph nodes were removed in all of the patients. Levels of the serum tumor marker CA 15-3 was determined prior to surgery and hormone receptors status were determined after the surgery.
Rotter's lymph nodes were identified in 67% of the patients, with metastatic involvement revealed in 20% of the Rotter's nodes. Metastatic involvement of Rotter's nodes in patients with negative and positive axillary lymph nodes was 4% and 35%, respectively. Of 35 Rotter's node-positive patients, 31.4% had elevated serum levels of tumor marker CA 15-3, with the level statistically significantly higher in Rotter's positive patients compared to those with negative (or absent) Rotter's nodes (
2=8.22, p= 0.0004). Hormone receptor status showed statistically significant difference in the expression of estrogen receptors and no statistically significant difference in progesteron receptors between patients with and those without positive Rotter's nodes (2=3.68; p=0.05 and 2=0.07;p=0.79).
The results show that one-fifth of breast cancer patients, or even one-third of them with positive axillary lymph nodes, are discharged with positive interpectoral lymph nodes that remain undiagnosed and non-extirpated. Tumor marker CA 15-3 is more frequently elevated in patients with positive Rotter's lymph nodes. Estrogen receptors are as well more frequently negative in such patients. Progesteron receptors show no difference in patients with positive or negative Rotter's lymph nodes. As the nodes can be surgically removed without additional mutilation, the exploration of Rotter's
lymph nodes should be introduced into routine clinical practice and the elevated values of tumor marker CA 15-3 could be warning for possible positive interpectoral nodes.
Ključne riječi
breast cancer; tumor marker CA 15- 3; hormone receptor status; interpectoral (Rotter's) lymph nodes
Hrčak ID:
281789
URI
Datum izdavanja:
3.12.2003.
Posjeta: 463 *