Clinical validity of tissue carcinoembryonic antigen expression as ancillary to serum carcinoembryonic antigen concentration in patients curatively resected for colorectal cancer

Park, J. W.; Chang, Hee Jin; Kim, B. C.; Yeo, Hyun Yang; Kim, D. Y.

doi:10.1111/codi.12304

Cited by 18 publications

(18 citation statements)

References 36 publications

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“…The role of carcinoembryonic antigen (CEA) as a robust predictor of long-term survival following resection of CRLM remains poorly defined [9,10,12,[18][19][20][21][22] . Among many patients, CEA can be an effective marker to monitor for recurrence, as well as to assess response to systemic therapy [18,21] .…”

Section: Preoperative Carcinoembryonic Antigen Levelmentioning

confidence: 99%

“…Other studies have similarly noted that preoperative CEA > 200 ng/mL was an independent factor of poor OS and disease specific survival (DSS), respectively [18,21] . In a one study, Park et al [19] looked at both tissue CEA and serum CEA concentration after resection for CRLM and noted that CEA expression was an independent prognostic factor for OS and DFS. Of note, patients with elevations in both tissue CEA expression and serum CEA had a worse OS and DFS compared with patients who had only one CEA category elevated [19] .…”

Section: Preoperative Carcinoembryonic Antigen Levelmentioning

confidence: 99%

“…In a one study, Park et al [19] looked at both tissue CEA and serum CEA concentration after resection for CRLM and noted that CEA expression was an independent prognostic factor for OS and DFS. Of note, patients with elevations in both tissue CEA expression and serum CEA had a worse OS and DFS compared with patients who had only one CEA category elevated [19] . Despite these data, other studies have noted that CEA level was not a significant predictor of survival or recurrence after hepatic resection for metastatic colorectal cancer [24][25][26][27] .…”

Section: Preoperative Carcinoembryonic Antigen Levelmentioning

confidence: 99%

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Surgery for colorectal liver metastases: The evolution of determining prognosis

Spolverato

Ejaz

Azad

et al. 2013

WJGO

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Despite improvements in the multi-modality treatment of colorectal liver metastasis (CRLM), survival after resection remains varied. Determining prognosis after surgical resection has historically been predicated on preoperative clinicopathological factors such as primary tumor stage, carcinoembryonic antigen levels, number of liver metastases, presence of extrahepatic disease, as well as other factors. While scoring systems have been developed by combining certain preoperative factors, these have been inconsistent in accurately determining prognosis. There has been increasing interest in the use of biologic and molecular markers to predict prognosis following CRLM. The role of markers such as KRAS, BRAF, p53, human telomerase reverse transcriptase, thymidylate synthase, Ki-67, and hypoxia inducible factor-1α and their correlation with accurately predicting survival after surgical resection have been supported by several studies. Furthermore, other elements such as pathological response to chemotherapy and the presence of circulating tumor cells have shown promise in accurately determining prognosis after resection for colorectal liver metastasis. We herein review past, present, and possible future markers of prognosis among colorectal cancer patients with liver metastasis undergoing resection with curative intent.© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Colorectal; Metastasis; Prognosis; Risk score; Molecular markers; Outcomes Core tip: Historically, prognosis after resection has been largely assessed based on preoperative clinicopathologic features. Data validating the prognostic value of patient and tumor specific factors have been mixed, with many recent studies showing these scoring systems to correlate poorly with survival. Rather, there has been an emerging interest in biological or molecular markers of prognosis to more effectively assess patient prognosis after resection of colorectal liver metastasis. In this review, we discuss past, present, and possible future markers of prognosis among colorectal cancer patients with liver metastasis undergoing resection with curative intent.

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Section: Preoperative Carcinoembryonic Antigen Levelmentioning

confidence: 99%

Section: Preoperative Carcinoembryonic Antigen Levelmentioning

confidence: 99%

Section: Preoperative Carcinoembryonic Antigen Levelmentioning

confidence: 99%

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Surgery for colorectal liver metastases: The evolution of determining prognosis

Spolverato

Ejaz

Azad

et al. 2013

WJGO

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“…However, another study reported that the grade of CEA expression in cancer tissue is related to the serum CEA level [16]. Such inconsistent results may be attributed to methodological differences in the evaluation of the CEA expression grade in tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have reported a positive relation between CEA levels in cancer tissue and serum CEA levels [16], whereas others have found no relation between these variables [17,18,19,20]. Currently available findings remain controversial.…”

Section: Introductionmentioning

confidence: 99%

Relation between Carcinoembryonic Antigen Levels in Colon Cancer Tissue and Serum Carcinoembryonic Antigen Levels at Initial Surgery and Recurrence

Saito¹,

Sadahiro²,

Okada³

et al. 2016

Oncology

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Objectives: Carcinoembryonic antigen (CEA) is widely used for postoperative surveillance of colon cancer. Even if serum CEA is negative at initial surgery, it may turn positive at recurrence. We investigated the relation between serum CEA levels and the immunohistochemical staining status of CEA in the primary and resected metastatic tissues. Methods: Out of 224 patients with recurrent colon cancer between 1998 and 2012, we studied 46 patients in whom serum CEA levels were measured and immunohistochemical staining for CEA was possible in the primary and metastatic tissues. Results: The positive rate of serum CEA did not differ between initial surgery and recurrence, regardless of whether the cutoff value was set at 5 or 10 ng/ml (p = 0.829, p = 0.671). There was no relation between the CEA staining status and serum CEA level at initial surgery. However, the CEA staining status of metastatic tissue was significantly related to the serum CEA level at recurrence (p = 0.0046 and p = 0.0026). Conclusions: The immunohistochemical staining status of CEA in metastatic tissue is closely related to the serum CEA level. This finding suggests that serum CEA levels are influenced not only by the CEA production capacity of cancer cells but also by the ability of the surrounding tissue to release CEA into the blood.

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Blood CEA levels for detecting recurrent colorectal cancer

Nicholson

Shinkins

Pathiraja

et al. 2015

Cochrane Database of Systematic Reviews

157

149

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CEA is insufficiently sensitive to be used alone, even with a low threshold. It is therefore essential to augment CEA monitoring with another diagnostic modality in order to avoid missed cases. Trying to improve sensitivity by adopting a low threshold is a poor strategy because of the high numbers of false alarms generated. We therefore recommend monitoring for colorectal cancer recurrence with more than one diagnostic modality but applying the highest CEA cut-off assessed (10 µg/L).

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Clinical validity of tissue carcinoembryonic antigen expression as ancillary to serum carcinoembryonic antigen concentration in patients curatively resected for colorectal cancer

Abstract: Tissue CEA expression is a prognostic factor in patients with colorectal cancer. Analysis of tissue CEA expression may be helpful in determining the clinical utility of serial measurements of serum CEA as surveillance in patients with curatively resected colorectal cancer.

Cited by 18 publications

References 36 publications

Surgery for colorectal liver metastases: The evolution of determining prognosis

Surgery for colorectal liver metastases: The evolution of determining prognosis

Relation between Carcinoembryonic Antigen Levels in Colon Cancer Tissue and Serum Carcinoembryonic Antigen Levels at Initial Surgery and Recurrence

Blood CEA levels for detecting recurrent colorectal cancer

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