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. 2018 Nov;7(11):5327-5338.
doi: 10.1002/cam4.1814. Epub 2018 Oct 9.

The role of tissue and serum carcinoembryonic antigen in stages I to III of colorectal cancer-A retrospective cohort study

Guojun Tong  1   2 , Wei Xu  3 , Guiyang Zhang  1 , Jian Liu  1 , Zhaozheng Zheng  1 , Yan Chen  1 , Pingping Niu  2 , Xuting Xu  2
Affiliations

The role of tissue and serum carcinoembryonic antigen in stages I to III of colorectal cancer-A retrospective cohort study

Guojun Tong et al. Cancer Med. 2018 Nov.

Abstract

Purpose: Tissue carcinoembryonic antigen (t-CEA) and serum carcinoembryonic antigen (s-CEA) expression profiles are the most useful tumor markers for the diagnosis and evaluation of colorectal cancer (CRC) worldwide; however, their roles in CRC progression remain controversial. This study aimed to compare the prognostic values of both s-CEA and t-CEA in CRC.

Methods: A total of 517 patients from January 2006 to December 2010 with stages I-III CRC were retrospectively examined, with 5-year postoperative follow-up and death as end-points. T-CEA expression, s-CEA expression, and clinical pathological parameters were inputted into the SPSS 21.0 software. The Kaplan-Meier method was used to analyze the 5-year disease-free survival (DFS) rate of patients in different tumor node metastasis (TNM) stages based on t-CEA and s-CEA expression.

Results: Tumor differentiation and the number of positive lymph node harvests were significantly different among the t-CEA groups (P < 0.001, P = 0.002); however, clinicopathological features showed no significant difference. The groups with high s-CEA and t-CEA expression had a significantly poorer prognosis than those with low s-CEA (P = 0.021) and t-CEA (P < 0.01) expression, respectively. The multivariate analysis demonstrated that t-CEA was an independent prognostic factor in CRC (P < 0.001), but s-CEA was not (P = 0.339). The 5-year disease-free survival rates among the t-CEA groups were significantly different in stages I, II, and III of CRC (P = 0.001, P < 0.001, P < 0.001), whereas in the s-CEA groups, this difference was observed only in stage III (P = 0.014).

Conclusion: This study shows that postoperative t-CEA expression is an independent factor associated with poorer CRC prognosis and has a higher prognostic value than that of preoperative s-CEA expression.

Keywords: carcinoembryonic antigen; colorectal carcinoma; prognosis.

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Figures

Figure 1
Figure 1
Study flow gram
Figure 2
Figure 2
A, B, C: using t‐CEA expression antibody staining, magnification of 200 times, the degree of expression were +, ++, +++, meaning the corresponding proportion (≤25%, >25%, ≤50%, >50% staining) in different degrees. The higher expression of t‐CEA showed the deeper staining.
Figure 3
Figure 3
A, B, C: T‐CEA group were calculated for different TNM staging by 5‐y disease‐free survival (DFS) by univariate analysis. A: I, B: II, C: III. I, II, III stage were significantly different, P < 0.05
Figure 4
Figure 4
A, B, C: S‐CEA group were calculated for different TNM staging by 5‐y disease‐free survival (DFS) by univariate analysis. A: I, B: II, C: III. Only III stage were significantly different, P < 0.05, and I, II stage was not significant, P > 0.05
Figure 5
Figure 5
The indicators with significant significance in univariate analysis were included in the COX risk regression analysis, using the entry method, and the first indicator was used as the indicator parameter to obtain the risk pattern. Multivariate COX regression analysis of risk maps suggest that t‐CEA is an independent prognostic factor and s‐CEA is not
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