Department of Surgery, Gil Medical Center, Gachon University of Medicine and Science, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, Republic of Korea.
Surg Oncol. 2012 Mar;21(1):45-51. doi: 10.1016/j.suronc.2010.10.003. Epub 2010 Nov 19.
OBJECTIVE/BACKGROUND: This study aimed to analyze the hypothesis that increased percentage drop in serum CEA post curative resection for colon cancer is associated with improved survival.
Five hundred thirty three patients who underwent colon resection with a curative intent were retrospectively analyzed for their pre- and postoperative CEA levels. The disease-free and overall survival curves were calculated using Kaplan Meier analysis to evaluate cancer related outcomes. For multivariate analysis, the Cox regression model was used.
The estimated 5-year overall survival for the preoperative serum CEA > 5 ng/mL group with respect to a postoperative CEA level drop rate of 40%, 50% and 60% were 72.9%, 80.9% and 81.8%, respectively. The estimated 5-year overall survival for the preoperative serum CEA ≤ 5 ng/mL group with respect to each postoperative CEA level drop rate were 86.6%, 97.1% and 97.7%, respectively (P = 0.257, P = 0.092 and P = 0.073, respectively). The prognostic factors for poor survival were the depth of invasion (p = 0.042, hazard ratio: 2.617, 95% CI = 1.021-3.012) and lymph node metastasis (p = 0.008, hazard ratio: 2.249, 95% CI = 1.231-4.111). A 60% drop of the CEA level was an independent prognostic factor for survival (p = 0.001, hazard ratio: 2.954, 95% CI = 1.686-5.176) for patients with a preoperative CEA level > 5 ng/mL.
Determining the preoperative CEA level and the early postoperative percent drop of the serum CEA level may be a helpful factor for the prognosis of colon cancer patients. However, the percent drop from the pre to postoperative CEA level from the normal range was not associated with survival difference.
目的/背景：本研究旨在分析假设，即结肠癌根治性切除术后血清 CEA 百分比下降幅度增加与改善生存相关。
回顾性分析了 533 例接受结肠癌根治性切除术的患者的术前和术后 CEA 水平。使用 Kaplan-Meier 分析计算无病生存和总生存曲线，以评估癌症相关结局。进行多变量分析时，使用 Cox 回归模型。
术前血清 CEA > 5ng/mL 组中，术后 CEA 下降率分别为 40%、50%和 60%时，估计的 5 年总生存率分别为 72.9%、80.9%和 81.8%。术前血清 CEA ≤ 5ng/mL 组中，每个术后 CEA 下降率的估计 5 年总生存率分别为 86.6%、97.1%和 97.7%（P = 0.257、P = 0.092 和 P = 0.073）。生存不良的预后因素为浸润深度（p = 0.042，风险比：2.617，95%CI = 1.021-3.012）和淋巴结转移（p = 0.008，风险比：2.249，95%CI = 1.231-4.111）。术前 CEA 水平 > 5ng/mL 的患者中，CEA 水平下降 60%是生存的独立预后因素（p = 0.001，风险比：2.954，95%CI = 1.686-5.176）。
确定术前 CEA 水平和术后早期血清 CEA 水平的百分比下降可能是结肠癌患者预后的一个有用因素。然而，从正常范围到术前到术后 CEA 水平的百分比下降与生存差异无关。
