Combined preoperative CEA and CD44v6 improves prognostic value in patients with stage I and stage II colorectal cancer
Combined preoperative CEA and CD44v6 improves prognostic value in patients with stage I and stage II colorectal cancer
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术前联合 CEA 和 CD44v6 可改善 I 期和 II 期结直肠癌患者的预后价值
DOI：
10.1007/s12094-013-1069-2
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发表时间：
2014-03-01
影响因子：
3.4
通讯作者：
Su, X.
中科院分区：
文献类型：
--
作者：
Chen, L.;Jiang, B.;Su, X.
目的联合应用多种生物标志物可能提高诊断水平，并具有较好的预后价值.本研究旨在探讨CEA和CD 44 v6联合检测对I/II期结直肠癌（CRC）预后的价值。方法采用电化学发光免疫分析法和免疫组化法分别检测术前血清CEA水平和CRC组织中CD 44 v6的表达。结果173例大肠癌患者术前血清CEA阳性率为30.1%（52/173），大肠癌组织中CD 44 v6阳性率为60.5%（101/167）。CEA水平升高或CD 44 v6阴性患者的疾病特异性生存率（DSS）低于CEA水平正常或CD 44 v6阳性患者（P= 0.024，P = 0.012）。CD 44 v6表达在CEA正常亚组中可作为判断预后好坏的指标（P= 0.043），而在CEA升高亚组中不能作为判断预后好坏的指标（P= 0.563）。多因素分析显示CEA和CD 44 v6联合是I/II期CRC患者的独立预后因素（P= 0.023）。然而，血清CEA水平仅保留了临界意义的相关性与更糟糕的DSS（P= 0.059），和CD 44 v6表达单独不是一个独立的预后因素DSS在多变量分析（P= 0.123）。结论这些结果表明，联合CEA/CD 44 v6有更好的预后价值比CEA或CD 44 v6单独为I/II期大肠癌患者。
AimCombination of biomarkers may improve diagnosis and have better prognostic value than single markers. The purpose of this study was to investigate whether combined CEA and CD44v6 improves prognostic value in stage I and stage II (stage I/II) colorectal cancer (CRC).MethodsPreoperative serum CEA level and the expression of CD44v6 in CRC tissues were examined by electrochemiluminescence immunoassay and immunohistochemistry, respectively. The association of CEA and CD44v6 with clinicopathological features and their possible prognostic values was analyzed.ResultsThe preoperative elevated serum CEA level and positive CD44v6 expression were detected in 30.1 % (52/173) serum samples and 60.5 % (101/167) CRC tissues, respectively. Patients with an elevated-CEA level or a CD44v6-negative tumor had a worse disease-specific survival (DSS) than those with a normal-CEA level or CD44v6-positive tumor (P= 0.024,P= 0.012, respectively). Moreover, CD44v6 expression could be used in discriminating patients from good to poor prognosis in normal-CEA subgroup (P= 0.043), but not in elevated-CEA subgroup (P= 0.563). Multivariate analysis revealed that combined CEA and CD44v6 was an independent prognostic factor for patients with stage I/II CRC (P= 0.023). However, serum CEA level only retained a borderline significance for correlation with a worse DSS (P= 0.059), and CD44v6 expression alone was not an independent prognostic factor for DSS in multivariate analysis (P= 0.123).ConclusionThese results suggested that combined CEA/CD44v6 had better prognostic value than CEA or CD44v6 alone for patients with stage I/II CRC.