Carcinoembryonic antigen mrna in the mesenteric vein is not a predictor of hepatic metastasis in patients with resectable colorectal cancer

Abstract

This study failed to demonstrate the high predictive value of carcinoembryonic antigen messenger ribonucleic acid detection in the draining venous blood for the development of hepatic metastases. However, the authors demonstrated that the presence of cancer cells in the draining venous blood was the essential and initial step to the development of hepatic metastasis.

Comparative Analysis of Tumor Markers and Evaluation of Their Predictive Value in Patients with Colorectal Cancer

“…Our data agrees with recent RT-PCR studies showingthatpatientspositiveforCEAorCK20mRNAhada significantlypoorerprognosisthanpatientsnegativeforthese markers [3,5,19]. HighlevelsofpreoperativeCEAareasignificantnegative prognosticmarkerforreducedoverallsurvivalaftersurgical resection of colorectal carcinomas [8,9,15], though CEA mRNA was not predictive for the development of hepatic metastasis [20].AlthoughCEAandCK20mRNAlevelswere higher in colorectal tumors when compared to non-tumor tissue, they were not related to staging or clinical development [21].PostoperativeCEAlevels,butnotCA19-9orp53 levels, were a significant prognostic factor for disease-free survivalofCRCpatients [22].Ourstudypopulationincluded 27postoperativepatientsand19patientswithorganmetasta-sesthatcouldnotbesurgicallyremoved.Patientspositivefor CEA mRNA had significantly shorter survival curves than thosenegativeforCEAmRNA,thoughCK20mRNA,serum CEAproteinlevels,andserumCA19-9proteinlevelshadno correlationwithoverallsurvival.Wesuggestthatthiscouldbe due to i) the small study population or ii) admixture of patientsatdifferentstagesofthedisease.WenotedthatCEA mRNAwashigherinstageIpatientsthaninstageIIpatients andwaspresentinsomeofthehealthyvolunteers,thoughwe donotcurrentlyhaveanexplanationforthis.However,CRC diagnosiswasnotbasedonCEAmRNAlevelsbutonpathologicalfindings.…”

Prognostic significance of CEA levels and detection of CEA mRNA in draining venous blood in patients with colorectal cancer

“…These results are in accordance with the ones reported by Taniguchi et al [16] who found that the positive rates of CEA mRNA increased significantly in patients with lymph node metastases and with lymphatic invasion. On the other hand, there are studies where no correlation could be detected between the presence of CEA mRNA and any clinicopathological factors including the ones mentioned above [20,25].…”

“…Akashi et al [25] in a study containing 80 patients, failed to demonstrate a high predictive value of CEA mRNA detection in the draining venous blood for the development of hepatic metastases. In his study, 80% of patients with positive CEA mRNA did not have hepatic metastases after surgery.…”

The serum level of carcinoembryonic antigen in drainage venous blood is not a sensitive predictor of metachronous hepatic metastasis for patients with colorectal cancer

“…27,28 Moreover, some investigators reported no appreciable difference between d-CEA levels and CEA mRNA expression. 28,29 Thus, the signifi cance of the d-CEA level remains open to debate.…”