Relationship between serum CA153,CA125 levels and drug resistance to endocrine therapy in elderly patients with Luminal breast cancer

SHENG Zhijuan; YANG Qinhui; DONG Aiping; HAN Baosan

doi:10.3969/j.issn.1674-4136.2024.05.007

Abstract：Objective Explore the relationship between serum levels of carbohydrate antigen 153(CA153),carbohydrate antigen 125(CA125)and drug resistance to endocrine therapy in elderly patients with Luminal breast cancer.Methods A total of 158 post-menopausal Luminal breast cancer patients over 60 years old who received endocrine therapy for breast cancer in Gansu Provincial Cancer Hospital from June 2018 to June 2022 were selected and divided into a drug-resistant group(n=104)and a sensitive group(n=54)according to whether drug resistence occurred.The general data of the two groups were compared.Spearman correlation analysis was used to analyze the relationship between serum CA153,CA125 level and clinicopathological features.Restricted cubic splines(RCS)model was used to analyze the dose-response relationship between serum CA153 and CA125 levels and endocrine drug resistance.Logisitic regression was used to analyze the risk factors of drug resistance in endocrine therapy.A clinical predictive model was established based on risk factors.Model one does not contain CA153,while model two contains all factors.ROC analysis and Hosmer-Lemeshow test were carried out on the two prediction models.Results The drug resistance rate of endocrine therapy was 65.83％.There were significant differences in age,tumor diameter,lymph node metastasis,T stage,N stage,histological grading,serum CA153 level and serum CA125 level between the two groups(P＜0.05).Serum CA153,CA125 levels were positively correlated with age,tumour diameter,lymph node metastasis,T-stage and N-stage,and serum CA153,CA125 levels were negatively correlated with histological grading.After adjusting for confounders,serum CA153 levels greater than 171.28 U/mL and CA125 levels greater than 186.32 U/mL were strongly correlated with endocrine therapy resistance.Logistic regression analysis showed that advanced age,larger tumor,higher T stage,higher N stage,histological classification G3,higher serum CA153 water and higher serum CA125 water were independent risk factors for drug resistance to endocrine therapy(P＜0.05).The area under the ROC curve of model 1 is 0.823(95％CI:0.702-0.862).The area under the ROC curve of model 2 is 0.884(95％CI:0.783-0.891).Hosmer-Lemeshow test showed that the prediction model one was 0.763 and the prediction model two was P=0.975.All of them suggested that the goodness of fit was good.Conclusions he level of serum CA153,CA125 can predict the drug resistance of endocrine therapy.The higher the serum CA153,CA125 level,the higher the risk of drug resistance to endocrine therapy.