Pre-operative to post-operative serum carcinoembryonic antigen ratio is a prognostic indicator in colorectal cancer.

Zhenqiang Sun,Jinbo Liu,Guixian Wang,Xiantao Sun,Shuaixi Yang,Weitang Yuan,Quanbo Zhou,Junmin Song,Zhen Li,Fuqi Wang,Zhiyong Zhang

doi:10.18632/oncotarget.17931

Abstract

We explored the prognostic significance of the pre-operative-to-post-operative serum carcinoembryonic antigen (pre-post-CEA) ratio in colorectal cancer (CRC). We detected pre- and post-operative CEA levels in 2035 CRC patients surgically treated at First Affiliated Hospital of Zhengzhou University between June 2001 and June 2011. Univariate analysis revealed the pre-post-CEA ratio is associated with distant metastasis and degree of tumor differentiation (both P < 0.05). Multivariate analysis showed that the pre-post-CEA ratio is associated with lymphatic and distant metastasis, tumor-node-metastasis (TNM) stage and degree of tumor differentiation (all P < 0.01). The pre-CEA levels, pre-post-CEA ratios, distant metastasis, TNM stage and degree of tumor differentiation were all associated with 5-yr overall survival (all P < 0.05) based on multivariate analysis. Consequently, pre-CEA levels, pre-post-CEA ratios, distant metastasis and TNM stage are independent risk factors for CRC. We have thus demonstrated that the pre-post-CEA ratio is a prognostic indicator for CRC patients.

Highlights

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer death worldwide with steadily increasing mortality rates [1, 2]
We explored the prognostic significance of the pre-operative-to-post-operative serum carcinoembryonic antigen ratio in colorectal cancer (CRC)
Univariate analysis showed that pre-carcinoembryonic antigen (CEA) levels were associated with smoking, tumor size, lymphatic and distant metastases and TNM stage (P < 0.05 for all parameters; Table 1)

Summary

Introduction

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer death worldwide with steadily increasing mortality rates [1, 2]. Tumor biomarkers have been widely used in clinical diagnosis, post-operative monitoring of tumor recurrence, prognosis and curative therapy of CRC patients [7]. The serum carcinoembryonic antigen (CEA) is one of the tumor biomarkers used for predicting recurrence, prognosis and therapeutic efficacy in CRC patients [8, 9]. Hotta et al reported that the pre-post-CEA ratio is prognostic predictor after surgery for stage III rectal cancer patients [10]. Another study reported that post-operative serum CEA (post-CEA) levels were more definitive as prognostic prediction than pre-post-CEA ratios in nonsmall cell lung cancer patients. In this study, we explored the prognostic relevance of pre-post-CEA ratios in predicting the survival time of CRC patients after radical surgery

Methods

Results

Conclusion