Deterministic Role of CEA and MSI Status in Predicting Outcome of CRC Patients: a Perspective Study Amongst Hospital Attending Eastern Indian Populations
Deterministic Role of CEA and MSI Status in Predicting Outcome of CRC Patients: a Perspective Study Amongst Hospital Attending Eastern Indian Populations
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DOI：
10.1007/s13193-017-0651-4
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发表时间：
2017-12-01
影响因子：
0.5
通讯作者：
Ashis, Mukhopadhyay
中科院分区：
文献类型：
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作者：
Koyel, Banerjee;Priyabrata, Das;Ashis, Mukhopadhyay
癌胚抗原（CEA）是预测结直肠癌（CRC）进展的重要决定性因素。同样明显的是，微卫星不稳定性（MSI）导致基因组DNA的高变表型在CRC中是常见的。由于缺乏来自印度的报告，我们这项研究的目的是了解CEA状态与手术和化疗的临床病理学相关性，与患者的社会人口统计学状态相关，确定其中的MSI状态，并了解CEA和MSI作为CRC进展标志物在患者中的预后意义。采用化学发光法（CLIA）测定血清CEA水平。血清肝酶测定按照制造商的说明书使用自动分析仪（E. Merck和Sera mol.卫生保健，印度）。采用PCR-SSCP方法进行MSI分析。从我们的研究来看，结直肠癌最常见的年龄组是40-49岁（25.26%），其中男性占61.05%，女性占38.95%。CEA与肿瘤的TNM分期、肿瘤大小、吸烟习惯和MSI有显著相关性（p < 0.05），但与性别和肿瘤部位无关（p > 0.05）。手术和化疗后，CEA和WBC明显下降（p < 0.05），而肝酶无明显变化（p > 0.05）。总体而言，在大约40%的人群中观察到微卫星不稳定性。从我们的研究中，也很明显，MSI和异常CEA水平预测患者的预后不良（通过使用Kaplan-Meier生存分析; p = 0.04）。因此，CEA和初始MSI状态可用作CRC的预后标志物。
Carcinoembryonic antigen (CEA) is an important deterministic factor in predicting colorectal carcinoma (CRC) progression. It is also evident that microsatellite instability (MSI) which results in a hypermutable phenotype of genomic DNA is common in CRC. Owing to the scarcity of reports from India, our aim of this study was to understand the clinicopathological correlations of CEA status with surgery and chemotherapy, correlate the same with socio-demographic status of the patients, determine the MSI status amongst them and understand the prognostic implications of CEA and MSI as CRC progression marker amongst patients. The serum CEA level was estimated by chemiluminescence assay (CLIA). Serum liver enzyme assay was carried out following the manufacturer's instructions using auto-analysers (E. Merck and Sera mol. Health Care, India). MSI analysis was carried out by PCR-SSCP. From our study, most frequently detected colorectal cancer was in 40-49 years age group (25.26%) with 61.05% male and 38.95% females. CEA showed a significant association with higher TNM staging, tumour size, smoking habit and MSI status (p < 0.05) but not with sex and site of cancer (p > 0.05). After surgery and chemotherapy, CEA and WBCs were decreased significantly (p < 0.05), while liver enzymes did not change significantly (p > 0.05). Overall, microsatellite instability was observed in approximately 40% of the populations. From our study, it was also evident that for both, MSI and abnormal CEA level predicted poor prognosis for the patient (by using Kaplan-Meier survival analysis; p = 0.04). Thus, CEA and initial MSI status can be used as prognostic markers of CRC.