Serum carcinoembryonic antigen to predict recurrence in the follow-up of patients with colorectal cancer

Abstract

Introduction: Serum carcinoembryonic (CEA) antigen is used as a diagnostic screening tool during follow-up in colorectal cancer patients. However, it remains unclear whether preoperative serum CEA is a reliable marker in the follow-up to predict recurrence. The aim of the study is to determine the value of elevated pre-and postoperative serum carcinoembryonic antigen levels (CEA > 5 µg/L) as an independent prognostic factor for locoregional and distant recurrence in patients who underwent curative surgery for colorectal cancer. Methods: This single center retrospective observational cohort study includes patients who underwent curative surgery for colorectal cancer between 2005 and 2015 and had pre-and postoperative serum CEA measurements. Five-year disease-free survival and multivariate Cox regression analyses were performed to adjust for confounding factors. Results: Preoperative serum CEA level was measured in 2093 patients with colorectal cancer. No significant association was found between an elevated preoperative serum CEA and locoregional recurrence (adjusted hazard ratio (HR) 1.29 (95% confidence interval (CI) 0.91, 1.84; P=0.26)). However, a significant association was found between an elevated preoperative serum CEA and systemic recurrence (adjusted HR 1.58 (95% CI 1.25, 2.00; P<0.01)]. The five-year diseasefree survival was lower in patients with elevated preoperative serum CEA levels (P<0.01). Postoperative serum CEA level was the most sensitive for hepatic metastases during follow-up (73.3%). Conclusions: The preoperative serum CEA level is an independent prognostic factor for systemic metastasis after curative surgery for colorectal cancer in patients with stage I-III disease. The level is the most sensitive for hepatic metastasis compared to metastasis to other anatomic sites.

Personalized Indicator Thrombocytosis Shows Connection to Staging and Indicates Shorter Survival in Colorectal Cancer Patients with or without Type 2 Diabetes

“…Results from clinical trials [54,55] suggests that compared to surgery alone, adjuvant chemotherapy improved the cure and decreased the risk of death. Recurrence rate for stage II is lower, compared to higher stages [56], but to date, no good marker has been found that may predict recurrences [57][58][59]. Although the present study could not provide data to supporting this hypothesis, but in our opinion, at the diagnosis of CRC or after primary surgery, when all staging data are available, calculating the PIT value could provide some guidance for future therapeutic decisions.…”

Current Surveillance After Treatment is Not Sufficient for Patients With Rectal Cancer With Negative Baseline CEA

“…8 Approximately 70% of colorectal tumors consist largely of CEA-negative cell lines, and they are documented to have scarce or no CEA secretion, 9 which is consistent with previous findings that CEA-negative tumors constitute 49% to 75% of CRCs. [10][11][12][13] Therefore, we speculated that the recurrent disease that develops from primary tumors with negative CEA tends to sustain a low serum CEA level in surveillance tests and that the role of CEA in surveillance for patients with negative baseline CEA needs to be evaluated with a cohort study.…”

Stable DNA Aptamer–Metal–Organic Framework as Horseradish Peroxidase Mimic for Ultra-Sensitive Detection of Carcinoembryonic Antigen in Serum

“…To demonstrate the potential of the CEA apt -TDN-MOF for clinical uses, the detection of CEA in human serum was carried out by using CEA apt -TDN-MOF and confirmed by standardized ELISA. According to clinical studies, the level of CEA in serum is closely related to the occurrence of colon cancer [ 33 , 34 ]. Therefore, the serum samples from healthy individuals, patients with early colon cancer, and patients with advanced colon cancer were used.…”