Abstract
The purpose of the study was to evaluate the prognostic significance of carcinoerembryonic antigen in patients with rectal cancer and correlate its baseline with the degree of therapeutic pathomorphosis after neoadjuvant chemoradiotherapy. Materials and methods. An estimate of the informative value of carcinoerembryonic antigen (CEA) indices in 179 patients with colorectal cancer determined before and after preoperative chemoradiotherapy (CRT) in SOD 50 Gy. Results. Analysis of the results presented in the study showed that in all patients, CRT caused a significant decrease in the level of CEA (–71%) 10 weeks after its end ( p < 0.001). In the course of the pathomorphological study, after the neoadjuvant treatment, the first degree of tumor pathomorphism was recorded in 4.5% of patients, II – 38.5%, III – 45%, IV – 12% (the degree of pathomorphosis is not related to the clinical stage and the degree of differentiation of colorectal cancer). It was revealed that patients with III and IV degrees of therapeutic pathomorphosis initially had a CEA level lower, in comparison with patients with grade I-II. Clinical progression of the disease is diagnosed in 24% of cases (43/179). It was noted that in patients with the IV degree of therapeutic pathomorphism of the tumor, no recurrence of the rectal cancer was detected in either case. Conclusion. The results of the study showed that the problem of individual prediction of the effectiveness of combined treatment of the rectal cancer remains very relevant, rather complicated and yet not completely solved. However, it can be assumed that the use of such an indicator as CEA in monitoring patients after the treatment, can serve as a criterion for the sensitivity of colorectal cancer to CRT. Initially low antigen level can be considered as a positive factor of tumor response to ongoing treatment and disease-free survival of patients with locally advanced rectal cancer.
Highlights
Рак прямой кишки (РПК) за последние 10–20 лет неуклонно наращивает свое присутствие в структуре онкологических заболеваний Российской Федерации [1]
Jeong S, Nam TK, Jeong JU, Kim SH, Kim K, Jang HS, et al Postoperative carcinoembryonic antigen level has a prognostic value for distant metastasis and survival in rectal cancer patients who receive preoperative chemoradiotherapy and curative surgery: a retrospective multi-institutional analysis
Prognosis can be predicted more accurately using pre-and postchemoradiotherapy carcinoembryonic antigen levels compared to only prechemoradiotherapy carcinoembryonic antigen level in locally advanced rectal cancer patients who received neoadjuvant chemoradiotherapy
Summary
Д.В.Ерыгин, Н.Г.Минаева, С.А.Иванов, Н.Ю.Двинских, Н.Ю.Новиков, Б.А.Бердов, А.А.Невольских, А.А.Карпов, Ю.Ю.Михалева, И.А.Евтехов, Л.О.Петров. Цыба – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения РФ, 249031, Российская Федерация, Калужская область, Обнинск, ул. Оценка прогностической значимости раково-эмбрионального антигена (РЭА) у больных раком прямой кишки и корреляции его исходного уровня со степенью лечебного патоморфоза после неоадъювантной химиолучевой терапии (ХЛТ). Проведена оценка информативности показателей РЭА у 179 больных раком прямой кишки (РПК), определяемого до и после предоперационной ХЛТ в суммарной очаговой дозе (СОД) Гр. В ходе патоморфологического исследования после неоадъювантного лечения I степень патоморфоза опухоли зафиксирована у 4,5% больных, II – 38,5%, III – 45%, IV– 12% (степень патоморфоза не связана с клинической стадией и степенью дифференцировки РПК). Оформление ссылки для цитирования статьи Ерыгин Д.В., Минаева Н.Г., Иванов С.А., Двинских Н.Ю., Новиков Н.Ю., Бердов Б.А., Невольских А.А., Карпов А.А., Михалева Ю.Ю., Евтехов И.А., Петров Л.О. Раково-эмбриональный антиген в прогнозировании лечебного патоморфоза опухоли после неоадъювантной химиолучевой терапии у больных раком прямой кишки. Tsyb Medical Radiological Research Centre – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation, 10 Marshala Zhukova str., Kaluga Region, Obninsk, 249036, Russian Federation
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