Evaluation of carcinoembryonic antigen (CEA) density as a prognostic factor for percutaneous ablation of pulmonary colorectal metastases

Huo, Ya Ruth; Glenn, Derek; Power, M.; Zhao, Jing

doi:10.1007/s00330-016-4352-0

Cited by 10 publications

(13 citation statements)

References 34 publications

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“…Despite many published studies that have demonstrated the prognostic impact of CEA among CRC patients, no agreement concerning the cutoff values has been established[20-24]. Moreover, Tong et al[12] found that postoperative tissue CEA is significantly associated with the prognosis of CRC, and Huo et al[13] illustrated that serum CEA density was an independent prognostic factor in patients with colorectal pulmonary metastasis. CEA, as a classic tumor marker, is used to evaluate the biological activity of malignancies, but biological activity will also be affected by tumor quantity.…”

Section: Discussionmentioning

confidence: 99%

“…Considering that detecting the CEA produced and secreted by all tumor cells is not realistic, using the ratio of CEA to tumor size may somehow reflect the ability of tumor cells to secrete CEA. Another research group demonstrated that CEA density is a prognostic factor for percutaneous ablation of pulmonary colorectal metastases[13]. Using tumor size to adjust and improve the prognostic value of tumor marker is not uncommon, such as prostate specific antigen density and tumor-infiltrating CD8+ T-cell density[14,15].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of preoperative carcinoembryonic antigen/tumor size in rectal cancer

Cai

Huang

et al. 2019

WJG

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BACKGROUNDCarcinoembryonic antigen (CEA) is a commonly used biomarker in colorectal cancer. However, controversy exists regarding the insufficient prognostic value of preoperative serum CEA alone in rectal cancer. Here, we combined preoperative serum CEA and the maximum tumor diameter to correct the CEA level, which may better reflect the malignancy of rectal cancer.AIMTo assess the prognostic impact of preoperative CEA/tumor size in rectal cancer.METHODSWe retrospectively reviewed 696 stage I to III rectal cancer patients who underwent curative tumor resection from 2007 to 2012. These patients were randomly divided into two cohorts for cross-validation: training cohort and validation cohort. The training cohort was used to generate an optimal cutoff point and the validation cohort was used to further validate the model. Maximally selected rank statistics were used to identify the optimum cutoff for CEA/tumor size. The Kaplan-Meier method and log-rank test were used to plot the survival curve and to compare the survival data. Univariate and multivariate Cox regression analyses were used to determine the prognostic value of CEA/tumor size. The primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively.RESULTSIn all, 556 patients who satisfied both the inclusion and exclusion criteria were included and randomly divided into the training cohort (2/3 of 556, n = 371) and the validation cohort (1/3 of 556, n = 185). The cutoff was 2.429 ng/mL per cm. Comparison of the baseline data showed that high CEA/tumor size was correlated with older age, high TNM stage, the presence of perineural invasion, high CEA, and high carbohydrate antigen 19-9 (CA 19-9). Kaplan-Meier curves showed a manifest reduction in 5-year OS (training cohort: 56.7% vs 81.1%, P < 0.001; validation cohort: 58.8% vs 85.6%, P < 0.001) and DFS (training cohort: 52.5% vs 71.9%, P = 0.02; validation cohort: 50.3% vs 79.3%, P = 0.002) in the high CEA/tumor size group compared with the low CEA/tumor size group. Univariate and multivariate analyses identified CEA/tumor size as an independent prognostic factor for OS (training cohort: hazard ratio (HR) = 2.18, 95% confidence interval (CI): 1.28-3.73, P = 0.004; validation cohort: HR = 4.83, 95%CI: 2.21-10.52, P < 0.001) as well as DFS (training cohort: HR = 1.47, 95%CI: 0.93-2.33, P = 0.096; validation cohort: HR = 2.61, 95%CI: 1.38-4.95, P = 0.003).CONCLUSIONPreoperative CEA/tumor size is an independent prognostic factor for patients with stage I-III rectal cancer. Higher CEA/tumor size is associated with worse OS and DFS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic value of preoperative carcinoembryonic antigen/tumor size in rectal cancer

Cai

Huang

et al. 2019

WJG

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“…Since the levels of CEA and AFP in the plasma remain valuable biomarkers for evaluating CRC progression ( 23 – 25 ), the potential association between ASPP mRNA expression and CEA or AFP concentrations in the samples was examined in the early and advanced groups ( Fig. 4 ).…”

Section: Resultsmentioning

confidence: 99%

The family of apoptosis-stimulating proteins of p53 is dysregulated in colorectal cancer patients

et al. 2018

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The apoptosis-stimulating protein of p53 (ASPP) family is a newly identified family protein including ASPP1, ASPP2 and inhibitor of ASPP (iASPP), by which the tumor protein 53 (TP53)-mediated apoptotic process is selectively regulated. Downregulation of ASPP1/ASPP2 and upregulation of iASPP were revealed to be associated with a poor prognosis and metastasis in several types of cancer. However, to the best of our knowledge, the expression of ASPP in colorectal cancer (CRC) has not previously been investigated. The present study analyzed ASPP expression in human CRC tissues with multiple clinical and pathological profiles. A total of 41 patients diagnosed with CRC were enrolled in the present study. The expression of ASPP was detected by immunohistochemistry, immunofluorescence and reverse transcription-quantitative polymerase chain reaction. In addition, the variation in ASPP expression was examined in a number of pathological groups. The associations among ASPP expression, and the expression of TP53, plasma carcinoembryonic antigen (CEA) levels and α-fetoprotein (AFP) levels were also investigated. ASPP1 and ASPP2 expression was significantly reduced, while iASPP expression was elevated in CRC samples compared with expression in adjacent non-cancerous tissues. Downregulation of ASPP1 was detected in the TP53-positive group compared with the TP53-negative group. The increase in iASPP expression was correlated with the grade of malignancy, but not with regional lymph node status or metastases. The expression of ASPP2 was negatively correlated with plasma CEA levels. The results of the present study, not only enrich CRC epidemic and pathological data, but also provide valuable indices for CRC clinical treatment and prognosis.

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“…It has been previously demonstrated that absolute serum CEA level is a strong independent prognostic factor for patients with advanced CRC and CRPC . In addition, Nakagoe et al identified that a high CEA concentration within tumor tissue was an independent poor prognostic factor, while Huo et al found serum CEA tumor density to be an independent prognostic factor in patients with colorectal pulmonary metastasis undergoing percutaneous ablation. These findings indicate that tumor marker levels may depict tumor biology rather than being simply a function of tumor quantity, with more aggressive tumours emitting higher quantities of CEA.…”

Section: Discussionmentioning

confidence: 99%

“…Tumor marker levels, such as CEA, may indicate tumor biological activity, rather than being simply a function of tumor quantity. Recent data indicates that serum CEA tumor density is an independent prognostic factor in patients with colorectal pulmonary metastasis undergoing percutaneous ablation, indicating that aggressive tumors emit higher quantities of circulating, measurable tumor markers.…”

Section: Introductionmentioning

confidence: 99%

CEA to peritoneal carcinomatosis index (PCI) ratio is prognostic in patients with colorectal cancer peritoneal carcinomatosis undergoing cytoreduction surgery and intraperitoneal chemotherapy

Kozman

Fisher

Rebolledo

et al. 2017

Journal of Surgical Oncology

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Evaluation of carcinoembryonic antigen (CEA) density as a prognostic factor for percutaneous ablation of pulmonary colorectal metastases

Cited by 10 publications

References 34 publications

Prognostic value of preoperative carcinoembryonic antigen/tumor size in rectal cancer

Prognostic value of preoperative carcinoembryonic antigen/tumor size in rectal cancer

The family of apoptosis-stimulating proteins of p53 is dysregulated in colorectal cancer patients

CEA to peritoneal carcinomatosis index (PCI) ratio is prognostic in patients with colorectal cancer peritoneal carcinomatosis undergoing cytoreduction surgery and intraperitoneal chemotherapy

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