Международный эндокринологический журнал Том 22, №1, 2026

Актуальність. Рак молочної залози є гетерогенним злоякісним новоутворенням і однією з провідних причин смертності, пов’язаної з онкологічними хворобами, серед жінок у всьому світі. Рецидиви залишаються серйозною проблемою довгострокового виживання й ефективного ведення пацієнток. Мета: визначити цінність циркулюючих біомаркерів (CA 15-3 та CEA) і стан гормональних рецепторів (рецептор естрогену (ER), рецептор прогестерону (PR) та рецептор людського епідермального фактора росту-2 (HER2)) для прогнозування рецидиву раку молочної залози, що таким чином розширить можливості діагностики захворювання на ранній стадії та дозволить розробити персоналізовані плани лікування. Матеріали та методи. Вивчено цінність сироваткових біомаркерів CA 15-3 та CEA, а також статус гормональних рецепторів (ER, PR, HER2) щодо прогнозування рецидиву раку молочної залози в перехресному обсерваційному дослідженні, яке проводилося з січня по жовтень 2025 року в клініці Al-Habboubi, Ірак. У нього включені пацієнтки з первинним діагнозом раку молочної залози, підтвердженим гістологічно. Аналіз біомаркерів за допомогою ELISA проводився на зразках крові, а імуногістохімічний аналіз — на зразках пухлини та в сумнівних випадках HER2 за допомогою тесту FISH. Результати. У дослідженні брали участь пацієнтки з раком молочної залози (середній вік 52,3 ± 10,4 року) та здорові жінки контрольної групи (50,8 ± 9,8 року). Хворі мали вищий індекс маси тіла (27,8 ± 4,2 кг/м2 проти 26,5 ± 3,9 кг/м2, P = 0,045) та більше випадків раку молочної залози в родинному анамнезі (26,7 проти 4 %, P < 0,001). Рівні сироваткових CA 15-3 і CEA були вірогідно підвищені в пацієнток (45,6 ± 12,3 Од/мл; 7,8 ± 2,4 нг/мл) порівняно з контрольною групою. Переважали випадки ER+ та PR+, при цьому HER2+ траплявся рідше. Уміст CA 15-3 та CEA корелював із ризиком рецидиву захворювання (r = 0,71, P < 0,001). Висновки. Високі рівні біомаркерів CA 15-3 та CEA, а також негативний статус ER/PR пов’язані зі збільшенням рецидивів раку молочної залози. Це вказує на більш агресивну біологію пухлини й гормональну регуляцію, що може обумовити використання цих біомаркерів у моніторингу й прогнозуваннi прогресування хвороби.

Background. Breast cancer is a heterogenous malignancy and is one of the leading causes of cancer-related mortality in women worldwide. Recurrence as a barrier to long-term survivorship and effective patient management is a formidable challenge. Aim of the study was to determine the prognostic value of circulating biomarkers (CA 15-3 and CEA) and the status of hormone receptors (estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2)) to predict recurrence of breast carcinoma, which will thus expand the diagnostic capacity of the disease in an early stage and guide personalized treatment plans. Materials and methods. The objectives of this study were to assess the predictive capacity of CA 15-3 and CEA serum biomarkers, as well as the hormonal receptor status (ER, PR, HER2) to predict breast cancer recurrence in this cross-sectional observational study, which was carried out in the period of January to October 2025 at Al-Habboubi Teaching Hospital, Iraq. It included female patients with a primary diagnosis of breast cancer that was confirmed by histopathology. ELISA biomarker analysis was performed on blood samples and immunohistochemistry on tumor specimens and equivocal cases of HER2 by FISH. Results. The study included female breast cancer patients (mean age 52.3 ± 10.4 years) and healthy controls (50.8 ± 9.8 years). Patients had higher body mass index (27.8 ± 4.2 vs. 26.5 ± 3.9 kg/m2, P = 0.045) and more family history of breast cancer (26.7 vs. 4 %, P < 0.001). Serum CA 15-3 and CEA levels were significantly elevated in patients (45.6 ± 12.3 U/mL, 7.8 ± 2.4 ng/mL) compared to controls. ER+ and PR+ were predominant, HER2+ was less common. CA 15-3 and CEA correlated strongly with recurrence risk, especially combined (r = 0.71, P < 0.001). Conclusions. High levels of serum CA 15-3 and CEA, as well as negativity on ER/PR are linked to increased recurrence of breast cancer. It indicates more aggressive tumor biology and hormonal regulation that may result in the usage of these biomarkers in the disease progression monitoring and prediction.

рак молочної залози; CA 15-3; CEA; гормональні рецептори; рецидив; біомаркери

breast cancer; CA 15-3; CEA; hormonal receptors; recurrence; biomarkers

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