Association between Primary Perioperative CEA Ratio, Tumor Site, and Overall Survival in Patients with Colorectal Cancer.
Association between Primary Perioperative CEA Ratio, Tumor Site, and Overall Survival in Patients with Colorectal Cancer.
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DOI：
10.3390/jcm9123848
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发表时间：
2020-11-27
影响因子：
3.9
通讯作者：
Kasi A
中科院分区：
文献类型：
--
作者：
Odeny TA;Farha N;Hildebrandand H;Allen J;Vazquez W;Martinez M;Paluri RK;Kasi A
结直肠癌(CRC)的发病率、临床表现、分子发病机制和预后因肿瘤部位不同而不同。新的研究表明，围手术期的癌胚抗原(CEA)比率(手术后/手术前CEA)是结直肠癌患者的一个预后因素。我们的目标是确定癌胚抗原比率、肿瘤部位和结直肠癌患者总生存期之间的关系。我们分析了427名在堪萨斯大学医学中心接受结直肠癌切除术的患者。在排除了那些没有手术前或手术后CEA数据的患者后，207名患者被分为高比率(≥为0.5)或低比率(<；0.5)。主要结果如下：(1)按CEA比率分层的OS；(2)按肿瘤位置分层的OS；(3)复发时CEA升高和>5 ng/mL的OS按肿瘤位置分层。生存率估计采用Kaplan-Meier法。中位年龄62岁(四分位数范围51-71)，男性占55%，吸烟者占41%，左侧肿瘤占71%，术前癌胚抗原中位数为3.1 ng/ml(四分位数范围为1.5-9.7)，57%癌胚抗原比值≥为0.5%。CEA比值高的患者OS率为65.1%，低CEA患者的OS率为86.3%(对数等级p值=0.045)。右侧肿瘤患者的OS率为64.4%，左侧肿瘤患者的OS率为77.3%(对数列P值=0.5)。在复发时CEA水平>5的患者中，右侧肿瘤患者的OS率为42.9%，左侧肿瘤患者的OS率为43.4%(对数等级p值=0.7)。CEA比率低的患者的存活率显著高于CEA比率高的患者。左侧和右侧肿瘤的OS差异无统计学意义。在复发时CEA升高<5 ng/mL的患者中，左侧肿瘤和右侧肿瘤之间的OS没有差异。这些发现需要在更大的队列中进行验证，因为我们的样本量有限。
There are differences in the incidence, clinical presentation, molecular pathogenesis, and outcome of colorectal cancer (CRC) based on tumor location. Emerging research suggests that the perioperative carcinoembryonic antigen (CEA) ratio (post-op/pre-op CEA) is a prognostic factor for CRC patients. We aimed to determine the association between CEA ratio, tumor location, and overall survival (OS) among patients with CRC. We analyzed 427 patients who underwent resection for CRC at the University of Kansas Medical Center. After excluding those without pre- or post-operative CEA data, 207 patients were classified as either high (≥0.5) or low (<0.5) ratio. Primary outcomes were as follows: (1) OS stratified by CEA ratio; (2) OS stratified by tumor location; (3) OS stratified by tumor location among those with CEA elevation > 5 ng/mL at the time of recurrence. The Kaplan–Meier method was used to estimate survival rates. The median age was 62 years (inter-quartile range 51–71), 55% were male, 41% were smokers, 71% had left-sided tumors, the median pre-operative CEA was 3.1 ng/mL (inter-quartile range (IQR) 1.5–9.7), and 57% had a CEA ratio ≥0.5. The OS rates were 65.1% and 86.3% in patients with high versus low CEA ratios, respectively (log-rank p-value = 0.045). The OS rates were 64.4% and 77.3% in patients with right-sided vs. left-sided tumors, respectively (log-rank p-value = 0.5). Among patients with CEA levels greater than 5 at the time of recurrence, the OS rates were 42.9% and 43.4% in patients with right-sided vs. left-sided tumors, respectively (log-rank p-value = 0.7). There was a significantly higher survival among patients with low CEA ratios than among those with high CEA ratios. There was no difference in OS between left- versus right-sided tumors. Among patients with CEA elevation > 5 ng/mL at the time of recurrence, there was no difference in OS between left versus right-sided tumors. These findings warrant validation in a larger cohort as our sample size was limited.
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影响因子：
28.4
作者：
Petrelli, Fausto;Tomasello, Gianluca;Barni, Sandro
通讯作者：
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影响因子：
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影响因子：
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作者：
Zheng, C.;Jiang, F.;Li, S.
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Harris PA;Taylor R;Thielke R;Payne J;Gonzalez N;Conde JG
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4
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Aoyama T;Kashiwabara K;Oba K;Honda M;Sadahiro S;Hamada C;Maeda H;Mayanagi S;Kanda M;Sakamoto J;Saji S;Yoshikawa T
通讯作者：
Yoshikawa T