Yuan Shu-Qiang, Zhou Zhi-Wei, Wan De-Sen, Chen Gong, Lu Zhen-Hai, Wang Guo-Qiang, Pan Zhi-Zhong
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China.
Ai Zheng. 2008 Jun;27(6):612-7.
BACKGROUND & OBJECTIVE: Carcinoembryonic antigen (CEA) monitoring plays an important role in the management of malignancies, especially in colorectal cancer (CRC). The half-life (T1/2) of CEA has also been applied as a new predictor in the surveillance of some malignancies. This study was to examine the preoperative and early postoperative levels of CEA in CRC patients and calculate postoperative T1/2 of CEA to evaluate its potential role in prognosis prediction.
In this retrospective study, 98 CRC patients who had preoperatively elevated levels of CEA (>or=5 microg/L) and serum CEA surveillance after radical operation were included. Postoperative T1/2 of CEA was calculated. Its correlation to prognosis was analyzed.
Of the 98 patients, 21 had local recurrence or distant metastasis (recurrence group), 77 had no recurrence (non-recurrence group). The median value of preoperative CEA level was significantly higher in recurrence group than in non-recurrence group (23.9 microg/L vs. 12.3 microg/L, P=0.010); the median value of postoperative T1/2 of CEA was significantly longer in recurrence group than in non-recurrence group (6.2 days vs. 4.7 days, P=0.042); the later the TNM stage was, the poorer the prognosis was (P<0.001). The 3-year disease-free survival (DFS) rate and overall survival (OS) rate were significantly higher in the patients with postoperative T1/2 of CEA of <4.8 days than in those with T1/2 of >or=4.8 days (87% vs. 66%, P=0.017; 90% vs. 80%, P=0.032). The patients at earlier TNM stage had survival benefits both in DFS and OS: the 3-year DFS rates in stage I, II, and III patients were 100%, 93%, and 55%, respectively (P<0.001); the 3-year OS rates were 100%, 98%, and 77%, respectively (P=0.192). In Cox regression analysis, both TNM stage and postoperative T1/2 of CEA were confirmed to be independent prognostic factors of CRC patients with preoperatively elevated CEA level.
In addition to TNM stage, the T1/2 of CEA may be an independent prognostic factor in CRC patients with preoperatively elevated CEA level. The patients with longer T1/2 of CEA after radical operation have poorer prognosis.
癌胚抗原（CEA）监测在恶性肿瘤管理中发挥着重要作用，尤其是在结直肠癌（CRC）中。CEA的半衰期（T1/2）也已被用作某些恶性肿瘤监测的新预测指标。本研究旨在检测CRC患者术前及术后早期的CEA水平，并计算术后CEA的T1/2，以评估其在预后预测中的潜在作用。
在这项回顾性研究中，纳入了98例术前CEA水平升高（≥5μg/L）且根治术后进行血清CEA监测的CRC患者。计算术后CEA的T1/2，并分析其与预后的相关性。
98例患者中，21例出现局部复发或远处转移（复发组），77例无复发（无复发组）。复发组术前CEA水平的中位数显著高于无复发组（23.9μg/L对12.3μg/L，P = 0.010）；复发组术后CEA的T1/2中位数显著长于无复发组（6.2天对4.7天，P = 0.042）；TNM分期越晚，预后越差（P < 0.001）。术后CEA的T1/2<4.8天的患者3年无病生存率（DFS）和总生存率（OS）显著高于T1/2≥4.8天的患者（87%对66%，P = 0.017；90%对80%，P = 0.032）。TNM分期较早的患者在DFS和OS方面均有生存获益：I期、II期和III期患者的3年DFS率分别为100%、93%和55%（P < 0.001）；3年OS率分别为100%、98%和77%（P = 0.192）。在Cox回归分析中，TNM分期和术后CEA的T1/2均被确认为术前CEA水平升高的CRC患者的独立预后因素。
除TNM分期外，CEA的T / 2可能是术前CEA水平升高的CRC患者的独立预后因素。根治术后CEA的T1/2较长的患者预后较差。
