Cargando…

Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA

BACKGROUND: Serum carcinoembryonic antigen (CEA) is an important biomarker for diagnosis, prognosis, recurrence, metastasis monitoring, and the evaluation of the effect of chemotherapy in colorectal cancer (CRC). However, few studies have focused on the role of early postoperative CEA in the prognos...

Descripción completa

Detalles Bibliográficos
Autores principales: Fenqi, Du, Yupeng, Liu, Qiuju, Zhang, Chao, Yuan, Wenjie, Song, Tianyi, Xia, Junnan, Guo, Weinan, Xue, Xiufeng, Jiang, Junge, Bai, Chenyang, Jia, Hua, Xi, Yien, Li, Xuefeng, Bai, Yanlong, Liu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786716/
https://www.ncbi.nlm.nih.gov/pubmed/35087748
http://dx.doi.org/10.3389/fonc.2021.758509
_version_ 1784639176763768832
author Fenqi, Du
Yupeng, Liu
Qiuju, Zhang
Chao, Yuan
Wenjie, Song
Tianyi, Xia
Junnan, Guo
Weinan, Xue
Xiufeng, Jiang
Junge, Bai
Chenyang, Jia
Hua, Xi
Yien, Li
Xuefeng, Bai
Yanlong, Liu
author_facet Fenqi, Du
Yupeng, Liu
Qiuju, Zhang
Chao, Yuan
Wenjie, Song
Tianyi, Xia
Junnan, Guo
Weinan, Xue
Xiufeng, Jiang
Junge, Bai
Chenyang, Jia
Hua, Xi
Yien, Li
Xuefeng, Bai
Yanlong, Liu
author_sort Fenqi, Du
collection PubMed
description BACKGROUND: Serum carcinoembryonic antigen (CEA) is an important biomarker for diagnosis, prognosis, recurrence, metastasis monitoring, and the evaluation of the effect of chemotherapy in colorectal cancer (CRC). However, few studies have focused on the role of early postoperative CEA in the prognosis of stage II CRC. METHODS: Patients with stage II CRC diagnosed between January 2007 and December 2015 were included. Receiver operating characteristic (ROC) curves were used to obtain the cutoff value of early postoperative CEA, CEA ratio and CEA absolute value. The areas under curves (AUCs) were used to estimate the predictive abilities of the CEA and T stage. The stepwise regression method was used to screen the factors included in the Cox regression analysis. Before and after propensity score (PS) - adjusted Cox regression and sensitivity analysis were used to identify the relationship between early postoperative CEA and prognosis. Meta-analysis was performed to verify the results. Kaplan-Meier survival curves were used to estimate the effects of CEA on prognosis. RESULTS: We included 1081 eligible patients. ROC curves suggested that the cutoff value of early postoperative CEA was 3.66 ng/ml (P <0.001) and the AUC showed early postoperative CEA was the most significant prognostic marker in stage II CRC (P = 0.0189). The Cox regression and sensitivity analysis before and after adjusting for PS both revealed elevated early postoperative CEA was the strongest independent prognostic factor of OS, DFS, and CSS (P < 0.001). Survival analysis revealed that patients with elevated early postoperative CEA had lower OS (53.62% VS 84.16%), DFS (50.03% VS 86.75%), and CSS (61.77% VS 90.30%) than patients with normal early postoperative CEA (P < 0.001). When the postoperative CEA was positive, the preoperative CEA level showed no significant effect on the patient’s prognosis (all P-values were > 0.05). Patients with a CEA ratio ≤0.55 or CEA absolute value ≤-0.98 had a worse prognosis (all P-values were < 0.001). Survival analysis suggested that adjuvant chemotherapy for stage II CRC patients with elevated early postoperative CEA may improve the CSS (P = 0.040). CONCLUSIONS: Early postoperative CEA was a better biomarker for prognosis of stage II CRC patients than T stage and preoperative CEA, and has the potential to become a high-risk factor to guide the prognosis and treatment of stage II CRC patients.
format Online
Article
Text
id pubmed-8786716
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-87867162022-01-26 Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA Fenqi, Du Yupeng, Liu Qiuju, Zhang Chao, Yuan Wenjie, Song Tianyi, Xia Junnan, Guo Weinan, Xue Xiufeng, Jiang Junge, Bai Chenyang, Jia Hua, Xi Yien, Li Xuefeng, Bai Yanlong, Liu Front Oncol Oncology BACKGROUND: Serum carcinoembryonic antigen (CEA) is an important biomarker for diagnosis, prognosis, recurrence, metastasis monitoring, and the evaluation of the effect of chemotherapy in colorectal cancer (CRC). However, few studies have focused on the role of early postoperative CEA in the prognosis of stage II CRC. METHODS: Patients with stage II CRC diagnosed between January 2007 and December 2015 were included. Receiver operating characteristic (ROC) curves were used to obtain the cutoff value of early postoperative CEA, CEA ratio and CEA absolute value. The areas under curves (AUCs) were used to estimate the predictive abilities of the CEA and T stage. The stepwise regression method was used to screen the factors included in the Cox regression analysis. Before and after propensity score (PS) - adjusted Cox regression and sensitivity analysis were used to identify the relationship between early postoperative CEA and prognosis. Meta-analysis was performed to verify the results. Kaplan-Meier survival curves were used to estimate the effects of CEA on prognosis. RESULTS: We included 1081 eligible patients. ROC curves suggested that the cutoff value of early postoperative CEA was 3.66 ng/ml (P <0.001) and the AUC showed early postoperative CEA was the most significant prognostic marker in stage II CRC (P = 0.0189). The Cox regression and sensitivity analysis before and after adjusting for PS both revealed elevated early postoperative CEA was the strongest independent prognostic factor of OS, DFS, and CSS (P < 0.001). Survival analysis revealed that patients with elevated early postoperative CEA had lower OS (53.62% VS 84.16%), DFS (50.03% VS 86.75%), and CSS (61.77% VS 90.30%) than patients with normal early postoperative CEA (P < 0.001). When the postoperative CEA was positive, the preoperative CEA level showed no significant effect on the patient’s prognosis (all P-values were > 0.05). Patients with a CEA ratio ≤0.55 or CEA absolute value ≤-0.98 had a worse prognosis (all P-values were < 0.001). Survival analysis suggested that adjuvant chemotherapy for stage II CRC patients with elevated early postoperative CEA may improve the CSS (P = 0.040). CONCLUSIONS: Early postoperative CEA was a better biomarker for prognosis of stage II CRC patients than T stage and preoperative CEA, and has the potential to become a high-risk factor to guide the prognosis and treatment of stage II CRC patients. Frontiers Media S.A. 2022-01-11 /pmc/articles/PMC8786716/ /pubmed/35087748 http://dx.doi.org/10.3389/fonc.2021.758509 Text en Copyright © 2022 Fenqi, Yupeng, Qiuju, Chao, Wenjie, Tianyi, Junnan, Weinan, Xiufeng, Junge, Chenyang, Hua, Yien, Xuefeng and Yanlong https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Fenqi, Du
Yupeng, Liu
Qiuju, Zhang
Chao, Yuan
Wenjie, Song
Tianyi, Xia
Junnan, Guo
Weinan, Xue
Xiufeng, Jiang
Junge, Bai
Chenyang, Jia
Hua, Xi
Yien, Li
Xuefeng, Bai
Yanlong, Liu
Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA
title Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA
title_full Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA
title_fullStr Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA
title_full_unstemmed Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA
title_short Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA
title_sort early postoperative serum carcinoembryonic antigen is a stronger independent prognostic factor for stage ii colorectal cancer patients than t4 stage and preoperative cea
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786716/
https://www.ncbi.nlm.nih.gov/pubmed/35087748
http://dx.doi.org/10.3389/fonc.2021.758509
work_keys_str_mv AT fenqidu earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT yupengliu earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT qiujuzhang earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT chaoyuan earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT wenjiesong earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT tianyixia earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT junnanguo earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT weinanxue earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT xiufengjiang earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT jungebai earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT chenyangjia earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT huaxi earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT yienli earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT xuefengbai earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea
AT yanlongliu earlypostoperativeserumcarcinoembryonicantigenisastrongerindependentprognosticfactorforstageiicolorectalcancerpatientsthant4stageandpreoperativecea