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. 2021 Jan-Dec:28:10732748211048292.
doi: 10.1177/10732748211048292.

Fecal CEA Has an Advantage in the Diagnosis of Colorectal Cancer at Early Stage

Linfang Li  1 , Shan Xing  1 , Miantao Wu  1 , Yufeng Ao  1 , Xin Zheng  1 , Rongzeng Cai  1 , Runkun Han  1 , Jingcong Li  1 , Xiaohui Li  1 , Qiuyao Zeng  1
Affiliations

Fecal CEA Has an Advantage in the Diagnosis of Colorectal Cancer at Early Stage

Linfang Li et al. Cancer Control. 2021 Jan-Dec.

Abstract

Purpose: Serum carcinoembryonic antigen (SCEA) level is often measured in patients with CRC but suffers from poor sensitivity and specificity as a diagnostic biomarker. CEA is more abundant in stool than in serum, but it has not been widely studied. This study aimed to elucidate the efficacy of fecal CEA (FCEA) as a potential non-invasive biomarker for early diagnosis of CRC.

Materials and methods: We retrospectively analyzed the determination of FCEA and SCEA levels by electrochemiluminescence. We evaluated the diagnostic accuracy of FCEA and SCEA levels in early-stage CRC patients and healthy controls using ROC curve.

Results: A total of 298 people were included: 115 patients with CRC, 35 patients with adenomatous polyp (APC), 46 patients with non-gastrointestinal cancer (NGC), and 102 healthy controls (HC). The FCEA concentrations in CRC and APC patients were significantly higher than that of NGC and HC, and this is different from SCEA expression in APC and NGC. As a diagnostic biomarker of CRC, FCEA had significantly larger AUC compared with SCEA (.802 vs .735, P < .001). For identifying early-stage colorectal cancer, FCEA showed better diagnostic efficacy (AUC: .831) than SCEA (AUC: .750), and the combination of the 2 biomarkers was even higher (AUC: .896). The sensitivity of FCEA was higher than that of SCEA (78.7% vs 29.8%). When SCEA was negative, 80.3% of CRC and 54.6% of APC cases could be identified by FCEA.

Conclusion: Compared with SCEA, FCEA has more advantages in the diagnosis of the early stage of colorectal cancer and adenomatous polyps.

Keywords: adenomatous polyps; colorectal cancer; early-stage; fecal CEA; serum CEA.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The distribution of SCEA and FCEA in each CRC stage and three control groups.
Figure 2.
Figure 2.
SCEA and FCEA compared the ROC curves of CRC versus non-gastrointestinal cancer and healthy controls.
Figure 3.
Figure 3.
(A) ROC comparisons of SCEA, FCEA, and combined (SCEA+ FCEA) to identify the early (Stage I + II) CRC from healthy controls. (B) The distribution of CRC and APC of FCEA in SCEA negative.
See this image and copyright information in PMC

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