Chemiluminometric determination of tissue polypeptide antigen (TPA), cancer antigen 15-3 (CA 15-3), carcinoembryonic antigen (CEA) in comparison with vascular endothelial growth factor (VEGF) in follow-up of breast cancer.

Vascular endothelial growth factor (VEGF), tissue polypeptide antigen (TPA), cancer antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA) were measured in 314 sera of breast cancer patients and in 58 sera of women without breast cancer. VEGF was determined using a sandwich enzyme immunoassay technique (ELISA) and the tumour markers TPA, CA 15-3 and CEA with an immunoluminometric assay (ILMA). The breast cancer patients were staged according to the TNM classification stages 0-IV (by UICC) in patient groups with a compatible prognosis. Median and range of each stage were investigated. The cut-off values (95th and 97.5th percentile of control group) of VEGF, TPA, CA15-3 and CEA were determined; sensitivities for each parameter and for all combinations of two parameters were investigated for these cut-offs and the receiver operating characteristic (ROC) curves were calculated. The differences between the control group and stages 0-3 were shown to be non-significant for CA 15-3 and CEA but significant for VEGF and TPA. Significant differences were found in stage 4 for VEGF and all three markers. The increase in sensitivity of VEGF from stage 0 to stage 3 and the decrease from stage 3 to stage 4 can be interpreted based on the role of VEGF in the angiogenesis. The quantification of VEGF could give additional information for selecting patients for systemic adjuvant therapy. Copyright 2000 John Wiley & Sons, Ltd.