Serum tissue polypeptide-specific antigen is an independent predictor in breast cancer

Tissue polypeptide-specific antigen (TPS) is a tumor proliferative marker associated with cytokeratin 18. The aim of the study was to investigate the potential relationship between the preoperative serum TPS levels and the outcome in Chinese breast cancer patients. 975 consecutive female patients, affected by invasive breast cancer under investigation from January 2005 to December 2011, had their TPS levels measured with a one-step solid phase radiometric sandwich assay detecting the M3 epitope on cytokeratin 18 fragments. The cut-off value was 80 U/L. The average age diagnosed with breast cancer was 48, ranging from 23 to 71. About 19% (185) patients displayed an elevated preoperative TPS level (>80 U/L) associated with older age (>45), advanced cancer stage, larger tumor size (>2 cm), axillary lymph node metastasis, negative progesterone receptor status, and positive HER2 status. In addition, preoperative TPS levels were also significantly connected with recurrence (p < 0.05), particularly distant metastasis and visceral metastasis. The mean preoperative TPS level was 68.4 ± 116.43 U/L (range 0–1839 U/L). In multivariate analysis, high preoperative TPS level was recognized as an independent prognostic factor for disease-free survival (p < 0.001 and overall survival (p = 0.023). From these results we conclude that the serum preoperative TPS level may be a valuable and independent marker for breast cancer.