Abstract
Background and PurposeThere had been no recognized serum tumor marker to predict the prognosis of colorectal cancer (CRC) patients with normal preoperative serum carcinoembryonic antigen (CEA) levels. The purpose of this study was to determine whether preoperative serum carbohydrate antigen 724 (CA724) was of predictive function for the prognosis of CRC patients with normal CEA levels.MethodsThe medical records of 295 CRC patients with normal CEA levels who underwent surgery at the Department of Colorectal Anal Surgery of the First Affiliated Hospital of Guangxi Medical University (Guangxi, China) between September 2012 and September 2014 were retrospectively reviewed. The Chi-square test was used to test the correlation between preoperative serum CA724 levels and clinical features. Kaplan–Meier curves were conducted to calculate the overall survival (OS) rate and disease-free survival (DFS) of patients. Cox regression analysis was applied to conduct univariate and multivariate analysis of the following four preoperative serum tumor makers namely CA724, carbohydrate antigen 199 (CA199), carcinoembryonic antigen 125 (CA125), carcinoembryonic antigen 242 (CA242) and clinical features. Nomograms for prognostic parameter of OS and DFS were developed using R v3.2.5.ResultsIn the Chi-square test, only pathological node stage (pN stage) (X2 = 14.514, P = 0.001) and differentiation (X2 = 10.712, P = 0.001) were associated with serum CA724 levels. In the Kaplan–Meier analysis, the results revealed that the OS and DFS in patients with high CA724 was poorer than those with normal. In the multivariate Cox regression analysis of OS and DFS, only pT stage, pN stage, metastasis and serum CA724 were independent prognostic risk factors for CRC patients with normal CEA levels.ConclusionPreoperative serum CA724 might serve as a potential prognostic factor for CRC patients with normal serum CEA levels.
Highlights
Colorectal cancer (CRC) is the third most common malignancy and the second most common cause of cancer-related mortality worldwide (Bray et al, 2018)
It was essential to identify other markers to predict the prognosis of colorectal cancer (CRC) patients
The following concentrations were considered to indicate high expression: carcinoembryonic antigen (CEA) > 5 ng/mL, carbohydrate antigen 199 (CA199) > 37 U/mL, carbohydrate antigen 724 (CA724) > 5.7 U/mL, carcinoembryonic antigen 242 (CA242) > 20.0 U/mL and carcinoembryonic antigen 125 (CA125) > 35.0 U/mL. These clinicopathological characteristics were collected in this study including age, gender, pathological tumor stage, pathological node stage, metastasis, tumor location, venous invasion, perineural invasion, pathologic type, differentiation, postoperative chemoradiotherapy
Summary
Colorectal cancer (CRC) is the third most common malignancy and the second most common cause of cancer-related mortality worldwide (Bray et al, 2018). Some markers to predict prognosis had been discovered for screening of risk for recurrence or metastasis (Feng et al, 2018; Nakamura & Yoshino, 2018). Their performance on clinic appliance was imperfect and some testing was only implemented in more comprehensive medical institutions due to the technology and expense. There had been no recognized serum tumor marker to predict the prognosis of colorectal cancer (CRC) patients with normal preoperative serum carcinoembryonic antigen (CEA) levels. In the multivariate Cox regression analysis of OS and DFS, only pT stage, pN stage, metastasis and serum CA724 were independent prognostic risk factors for CRC patients with normal CEA levels. Conclusion: Preoperative serum CA724 might serve as a potential prognostic factor for CRC patients with normal serum CEA levels
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