Serum sE-Selectin Levels and Carcinoembryonic Antigen mRNA-Expressing Cells in Peripheral Blood as Prognostic Factors in Colorectal Cancer Patients
Serum sE-Selectin Levels and Carcinoembryonic Antigen mRNA-Expressing Cells in Peripheral Blood as Prognostic Factors in Colorectal Cancer Patients
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DOI：
10.1002/cncr.25094
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发表时间：
2010-06-15
期刊：
影响因子：
6.2
通讯作者：
Guadagni, Fiorella
中科院分区：
文献类型：
--
作者：
Ferroni, Patrizia;Roselli, Mario;Guadagni, Fiorella
背景：本研究分析了术前血清可溶性e-选择素(s)水平和/或癌胚抗原（CEA） mRNA阳性在预测结直肠癌（CRC）患者无病生存中的可能预后价值。方法：分析78例原发性（n = 62）或复发性（n = 16）结直肠癌患者、40例良性结直肠（CR）疾病患者和78例对照患者血液样本中的CEA mRNA（通过逆转录聚合酶链反应[RT-PCR]从血源性细胞中获得）、肿瘤坏死因子- α (tnf - α)和硒选择素水平。结果：经RT-PCR检测CEA mRNA阳性与患者病情进展有显著相关性（P < 0.05）。与对照组（36 ng/mL）或良性CR疾病患者（31 ng/mL, P < 0.001）相比，CRC患者中位基线sE-selectin水平（43 ng/mL）更高。RT-PCR结果显示，这些与CEA mRNA阳性有显著相关性（P < 0.05）。正演多因素分析显示，TNF-a升高（P = 0.001）和CEA mRNA阳性（P = 0.0001）是基线se -选择素水平升高的独立预测因子。与低水平的患者相比，术前se -选择素水平阳性与复发率增加相关（P < 0.001）。CEA mRNA和sE-selectin均呈阳性对预后有负面影响，5年无复发生存率为51%，阴性患者为95% （P < 0.05）。结论：检测结直肠癌患者手术前血清硒选择素水平和CEA mrna阳性血源性细胞可能为无复发生存提供有用的预后信息，无论是单独还是联合，并可能有助于高危患者选择更积极的治疗和/或更严格的随访程序。癌症2010;116:2913-21。(C) 2010年美国癌症协会。
BACKGROUND: This study analyzed the possible prognostic value of presurgical serum soluble (s)E-selectin levels and/or carcinoembryonic antigen (CEA) mRNA positivity in predicting the disease-free survival of colorectal cancer (CRC) patients. METHODS: CEA mRNA (obtained from blood-borne cells by reverse transcriptase-polymerase chain reaction [RT-PCR]), tumor necrosis factor-alpha (TNF-alpha), and sE-selectin levels were analyzed in blood samples obtained from 78 patients with primary (n = 62) or recurrent (n = 16) CRC, 40 patients with benign colorectal (CR) diseases, and 78 controls. RESULTS: CEA mRNA positivity by RT-PCR was significantly associated with advanced stage (P < .05). Median baseline sE-selectin levels were higher in patients with CRC (43 ng/mL) compared with controls (36 ng/mL) or patients with benign CR diseases (31 ng/mL, P < .001). These were significantly associated with CEA mRNA positivity by RT-PCR (P < .05). Multivariate analysis by forward stepping showed that elevated TNF-a (P = .001) and CEA mRNA positivity by RT-PCR (P = .0001) were independent predictors of elevated baseline sE-selectin levels. Positive presurgical sE-selectin levels were associated with an increased recurrence rate compared with patients with low levels of this molecule (P < .001). Positivity for both CEA mRNA and sE-selectin had a negative prognostic impact, with a 5-year recurrence-free survival rate of 51% compared with 95% of patients with negative parameters (P < .05). CONCLUSIONS: Detection of presurgical serum sE-selectin levels and CEA mRNA-positive blood-borne cells in CRC patients might provide useful prognostic information in terms of recurrence-free survival, either alone or in combination, and may help in the choice of more aggressive treatment and/or more strict follow-up procedures in high-risk patients. Cancer 2010;116:2913-21. (C) 2010 American Cancer Society.