To explore the change of serum cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and carbohydrate antigen 125 (CA125) levels before and after neoadjuvant chemotherapy in patients with breast cancer and their relationship with the efficacy.

Totally 80 breast cancer patients in the Fifth People’s Hospital of Qinghai Province from March 2015 to March 2018 were enrolled for a retrospective study. All patients were treated with neoadjuvant chemotherapy of docetaxel+ adriamycin+ cyclophosphamide (TAC) regimen. The serum CYFRA21-1 and CA125 levels were detected by the enzyme-linked immunosorbent assay. The relationship between serum CYFRA21-1 and CA125 levels and the efficacy of neoadjuvant chemotherapy was analyzed. The independent sample t test was used for comparison between groups. The paired t test was used for the comparison before and after treatment in the same group. The receiver operating characteristic(ROC) curve was used to analyze the predictive value of different methods (CYFRA21-1, CA125, CYFRA21-1 combined with CA125) in evaluating the efficacy of chemotherapy.

The serum levels of CYFRA21-1 and CA125 in patients with breast cancer after chemotherapy were significantly lower than those before chemotherapy [(4.51±0.53) ng/ml vs (4.95±0.65) ng/ml, t=4.692, P<0.001; (250.34±28.63) U/ml vs (275.42±30.52) U/ml, t=5.361, P<0.001]. The chemotherapy proved effective in 36 patients (8 with complete remission and 28 with partial remission), ineffective in 44 patients (26 with stable disease and 18 with disease progression), and the effective rate of chemotherapy was 45.0% (36/80). In effective chemotherapy group, serum levels of CYFRA21-1 and CA125 after chemotherapy were significantly lower than those before chemotherapy [(3.22±0.47) ng/ml vs (4.94±0.53) ng/ml, t=14.568, P<0.001; (180.34±22.42)U /ml vs (274.21±30.82) U/ml, t=14.778, P <0.001]. In ineffective chemotherapy group, serum levels of CYFRA21-1 and CA125 after chemotherapy were significantly higher than those before chemotherapy [(6.21±0.84) ng/ml vs (4.97±0.55) ng/ml, t=8.192, P<0.001; (310.26±37.34) U/ml vs (276.12±30.92) U/ml, t=4.671, P<0.001]. ROC curve analysis showed that in assessing the efficacy of neoadjuvant chemotherapy in breast cancer patients, the sensitivity, specificity, accuracy, and area under the curve was 77.78%(28/36), 81.82%(36/44), 80.00%(64/80)and 0.762 for CYFRA21-1 (critical value: the reduction ratio >10%), 72.22%(26/36), 77.27%(34/44), 75.00%(60/80)and 0.758 for CA125 (critical value: the reduction ratio >12%), 94.44%(34/36), 95.45%(42/44), 95.00%(76/80) and 0.906 for the combination of both factors. The accuracy and area under the curve in combination of both were significantly higher than those when either factor was used (all P <0.017).

The changes of serum CYFRA21-1 and CA125 levels in breast cancer patients before and after neoadjuvant chemotherapy are related to the efficacy of neoadjuvant chemotherapy, so CYFRA21-1 and CA125 can be used as indicators for efficacy evaluation, and the combination of both may have a better predictive value.