Unrecognized Value of Carcinoembryonic Antigen in Recurrent Rectal and Sigmoid Colon Cancer: Case Series

Yavorkovsky, Leonid L.; Kwong, Myron S; Jhatakia, Sejal; Ivanov, P.I.

doi:10.7812/tpp/18-022

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…Several guidelines recommend CEA as a biomarker for CRC prognosis and suggest that CEA should be routinely measured in patients with non-metastatic CRC (8,9). It has been known that elevated preoperative CEA (pre-CEA) is related to distant metastasis or worse outcomes of CRC (10,11), but some researchers propose that the sensitivity and specificity of pre-CEA in identifying high-risk CRC patients are limited (12,13). Recently, a few studies focus on the prognostic role of the postoperative CEA (post-CEA) level and illustrated that post-CEA was a more valuable biomarker than pre-CEA in distinguishing CRC prognosis (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of and Predictive Risk Factors for the Postoperative Elevation of Carcinoembryonic Antigen in Patients With Non-Metastatic Colorectal Cancer

et al. 2021

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BackgroundRecently, a few researches focus on the correlation between postoperative carcinoembryonic antigen (post-CEA) and the outcome of colorectal cancer (CRC), but none investigates the predictive value of post-CEA in a prognostic model. Besides, current recommendations on the frequency of post-CEA surveillance are not individualized and well followed. There is an absence of identification of patients who are more likely to have abnormal post-CEA levels and need more frequent CEA measurements.MethodsConsecutive CRC patients who underwent curative surgery were enrolled and randomly divided into the discovery (n=352) and testing cohort (n=233). Impacts of preoperative CEA (pre-CEA) and post-CEA on prognosis were assessed. Cox regression model was applied to develop prognostic nomograms, which were validated by the concordance index (C-index), calibration curve, and receiver operating characteristic curve (ROC) analysis. And prediction improvement of the nomograms was assessed with net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Logistic regression was used to identify predictive risk factors and construct the prediction model for post-CEA elevation.ResultsPost-CEA independently predicted overall survival (OS) and disease-free survival (DFS), while pre-CEA did not. Post-CEA elevation represented higher risks in patients with normal pre-CEA, compared to those with persistent elevated CEA. The nomograms for OS and DFS were established with body mass index, tumor differentiation, N stage, lymphocyte-to-monocyte ratio, and post-CEA. The nomograms showed good calibration and superior discrimination than pTNM stage, with the C-index of 0.783 and 0.759 in the discovery set and 0.712 and 0.774 in the testing set for OS and DFS, respectively. Comparisons between models using IDI and NRI implied that the nomograms performed better than pTNM stage and the predictive power could be improved with the addition of post-CEA. The prediction model for post-CEA elevation was established with age, platelet-to-lymphocyte ratio, preoperative CA19-9, and pre-CEA. The AUC of the model in the two cohorts was 0.802 and 0.764, respectively.ConclusionsElevated post-CEA was a strong indicator of poor prognosis. The addition of post-CEA significantly enhanced the performance of prognostic nomograms. And the prediction model for post-CEA elevation may help identify patients who ought to reasonably receive more intensive postoperative surveillance of CEA levels.

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Section: Introductionmentioning

confidence: 99%

Clinical Significance of and Predictive Risk Factors for the Postoperative Elevation of Carcinoembryonic Antigen in Patients With Non-Metastatic Colorectal Cancer

et al. 2021

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Exploring the integration of nanotechnology in the development and application of biosensors for enhanced detection and monitoring of colorectal cancer

Hajjafari,

Sadr,

Rahdar

et al. 2024

Inorganic Chemistry Communications

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Postoperative serum CA19-9, YKL-40, CRP and IL-6 in combination with CEA as prognostic markers for recurrence and survival in colorectal cancer

et al. 2020

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Background:In colorectal cancer (CRC) patients, guidelines only recommend measurement of pre-operative carcinoembryonic antigen (CEA), although post-operative CEA may be more informative.However, the sensitivity of both pre-operative and post-operative CEA in identifying relapse is limited. We studied whether CA19-9, YKL-40, C-reactive protein (CRP), and interleukin (IL)-6 add prognostic information combined with post-operative CEA.

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Unrecognized Value of Carcinoembryonic Antigen in Recurrent Rectal and Sigmoid Colon Cancer: Case Series

Cited by 4 publications

References 13 publications

Clinical Significance of and Predictive Risk Factors for the Postoperative Elevation of Carcinoembryonic Antigen in Patients With Non-Metastatic Colorectal Cancer

Clinical Significance of and Predictive Risk Factors for the Postoperative Elevation of Carcinoembryonic Antigen in Patients With Non-Metastatic Colorectal Cancer

Exploring the integration of nanotechnology in the development and application of biosensors for enhanced detection and monitoring of colorectal cancer

Postoperative serum CA19-9, YKL-40, CRP and IL-6 in combination with CEA as prognostic markers for recurrence and survival in colorectal cancer

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