Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients with chronic kidney disease

Huang, Chiung‐Shiann; Huang, Li; Chen, Chin Yau; Wang, Wei Shu; Yang, Shung Haur

doi:10.1016/j.amjsurg.2020.07.015

Cited by 8 publications

(4 citation statements)

References 34 publications

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“…Between January 2012 and October 2021, patients with CRC who underwent radical resection of primary lesions at Hainan Hospital of Chinese People's Liberation Army (PLA) General Hospital (Sanya, China) were retrospectively included in the present study. Patients meeting any one of the following criteria were excluded: i) Patients with an absence of preoperative laboratory test results or abnormal aminotransferase or serum creatinine levels, since such abnormalities could cause an altered metabolism or excretion of CEA ( 27 , 28 ); ii) patients with distant lesions; iii) patients who were missing any TNM information in their postoperative pathological reports; iv) patients with multiple or recurrent malignancies or in situ lesions; v) and patients with a follow-up time of <36 months. In addition, patients who received neoadjuvant chemotherapy were also excluded, since such therapy could cause problems in being able to accurately confirm the pT/pN stages in post-operative pathological findings, in particular for those who reached a tumor regression grading of 2 or 3 ( 29 ).…”

Section: Methodsmentioning

confidence: 99%

Preoperative carcinoembryonic antigen to body mass index ratio contributes to prognosis prediction in colorectal cancer

et al. 2022

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Both carcinoembryonic antigen (CEA) level and body mass index (BMI) are traditional prognostic markers in colorectal cancer (CRC); however, to the best of our knowledge, the value of the CEA to BMI ratio (CBR) has never been addressed. In the present study, 191 patients with CRC treated using radical resection were retrospectively included, and the significance of the CBR in predicting disease-free survival (DFS) or overall survival (OS) rates was calculated. The prognostic efficacy of the CBR in predicting OS was compared with individual CEA and BMI values. The survival differences of the subgroups were calculated by Kaplan-Meier analysis, and corresponding risk factors were then estimated by a Cox proportional hazards model. As a result, 29.84% (57/191) of the patients were assigned to the high CBR group (cut-off, ≥0.28); the CBR had a sensitivity of 56.50 and 68.90%, and a specificity of 80.60 and 80.10% for DFS and OS, respectively. Patients with a high CBR more commonly underwent laparotomy and exhibited advanced T stages, the presence of tumor deposits and advanced Tumor-Node-Metastasis stages (stage II or III). The CBR was more efficient than the CEA or BMI alone in predicting OS. In addition, patients with a high CBR presented with a significantly worse outcome than patients with a low CBR. Finally, the CBR was an independent risk factor for both DFS and OS. In conclusion, the CBR was a more robust prognostic factor in CRC, and patients with a relatively high CBR exhibited poorer survival.

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Section: Methodsmentioning

confidence: 99%

Preoperative carcinoembryonic antigen to body mass index ratio contributes to prognosis prediction in colorectal cancer

et al. 2022

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“…We incubated serumstarved HCT-116 cells for various periods with or without indoxyl sulfate (250 μM). Total RNA was University Hospital in Taipei, Taiwan, had preoperative CKD (Huang et al 2021). In addition, 21.8% of patients with stage 0-III primary CRC who underwent curative resection between January 2001 and December 2010 at the University of Tokyo in Tokyo, Japan, had CKD stage III-V (Nozawa et al 2012).…”

Section: Materials and Reagentsmentioning

confidence: 99%

Indoxyl sulfate contributes to colorectal cancer cell proliferation and increased EGFR expression by activating AhR and Akt

ICHISAKA,

YANO,

NISHIMURA

et al. 2024

Biomed. Res.

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Although patients with chronic kidney disease (CKD) have a higher risk of colorectal cancer (CRC) aggravation, the connection between these two diseases is not well understood. Recent studies have shown that both CKD and CRC aggravation are closely related to an increased abundance of indole-producing Fusobacterium nucleatum in the gut. The indole absorbed from the gut is eventually metabolized to indoxyl sulfate in the liver. Since indoxyl sulfate is involved not only in accelerating CKD progression but also in the initiation and development of its associated complications, the present study aimed to clarify whether indoxyl sulfate induces the proliferation of CRC cells. This study found that indoxyl sulfate induced the proliferation of CRC-derived HCT-116 cells by activating the aryl hydrocarbon receptor (AhR) and the proto-oncogene Akt. The AhR antagonist CH223191 and Akt inhibitor MK2206 suppressed indoxyl sulfate-induced proliferation of HCT-116 cells. We also found that indoxyl sulfate upregulated epidermal growth factor receptor (EGFR) expression, which is associated with poor prognosis of CRC, whereas CH223191 and MK2206 repressed EGFR expression. Furthermore, indoxyl sulfate increased the sensitivity of CRC cells to EGF by upregulating EGFR expression. These findings suggest that indoxyl sulfate may be an important link between CKD and CRC aggravation.

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“…suggested that CKD patients might be more likely to develop cardiovascular complications after CRC resection and had an increased risk of disease-free survival (DFS) ( 13 ); Huang CS et al. found that the CKD group had a significantly lower 3-year DFS rate compared to the Non-CKD group ( 14 ); Moreover, Nozawa H et al. concluded that CKD had little effect on overall survival (OS) in TNM stage III CRC patients ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Does chronic kidney disease affect the short-term outcomes and prognosis of colorectal cancer surgery? A propensity score matching analysis

Qu,

Rao,

Hai

et al. 2024

Front. Oncol.

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PurposeThe aim of this study was to analyze the effect of chronic kidney disease (CKD) on the short-term outcomes and prognosis of colorectal cancer (CRC) patients who underwent primary surgery.MethodsCRC patients who underwent radical surgery were included from Jan 2011 to Jan 2020 in a single hospital. The short-term outcomes and prognosis were compared between the CKD group and the Non-CKD group using propensity score matching (PSM) analysis.ResultsA total of 4056 patients undergoing CRC surgery were included, including 723 patients in the CKD group and 3333 patients in the Non-CKD group. After 1:1 PSM, there were 666 patients in each group, respectively. No significant difference was found in baseline characteristics between the two groups. (p>0.05). After PSM, the CKD group had a longer postoperative hospital stay (P=0.009) and a higher incidence of overall complications (p=0.050). Cox analysis was performed on matched patients to find predictors of overall survival (OS) and disease-free survival (DFS). We found that age (p<0.01, HR=1.045, 95% CI=1.028–1.062), tumor stage (p<0.01, HR=1.931, 95% CI=1.564–2.385) and overall complications (p<0.01, HR=1.858, 95% CI=1.423–2.425) were independent predictors of OS. Age (p<0.01, HR=1.034, 95% CI=1.020–1.049), tumor stage (p<0.01, HR=1.852, 95% CI=1.537–2.231), and overall complications (p<0.01, HR=1.651, 95% CI=1.295–2.10) were independent predictors of DFS. However, CKD was not an independent predictor of OS or DFS (OS: p=0.619, HR=1.070, 95% CI=0.820–1.396; DFS: p=0.472, HR=1.092, 95% CI=0.859–1.389).ConclusionCKD prolonged postoperative hospital stay; however, CKD might not affect major postoperative complications, OS or DFS of CRC.

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Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients with chronic kidney disease

Cited by 8 publications

References 34 publications

Preoperative carcinoembryonic antigen to body mass index ratio contributes to prognosis prediction in colorectal cancer

Preoperative carcinoembryonic antigen to body mass index ratio contributes to prognosis prediction in colorectal cancer

Indoxyl sulfate contributes to colorectal cancer cell proliferation and increased EGFR expression by activating AhR and Akt

Does chronic kidney disease affect the short-term outcomes and prognosis of colorectal cancer surgery? A propensity score matching analysis

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