McGill University Health Center, Montreal, QC, Canada.
Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada.
J Otolaryngol Head Neck Surg. 2018 Sep 17;47(1):55. doi: 10.1186/s40463-018-0303-x.
Medullary thyroid cancer (MTC) cells are capable of secreting various tumor markers including calcitonin and carcinoembyronic antigen (CEA). The purpose of this study is to determine whether abnormal CEA levels may be used as a tumor marker to predict the severity of disease in MTC.
A retrospective analysis was completed for 33 patients with MTC who had preoperative serum CEA levels. Univariate and multivariate analyses were used to quantify the relationship between serum CEA levels and tumor stage and prognosis.
On multivariate analysis, elevated preoperative CEA levels were significantly associated with the size and stage of tumor, distant metastasis, decreased biochemical cure, and mortality. There was a significant association between tumor size greater than 37 mm and elevated CEA levels (> 271 ng/ml). There was also a positive correlation with increased cancer stage (> 377 ng/ml), distant metastasis (> 405 ng/ml), and contralateral compartment location of lymph node metastasis (> 162 ng/ml). When pre-operative CEA levels are > 500 ng/ml, patient mortality was 67%.
In this study, both pre-operative calcitonin and CEA levels were significantly correlated with the extent of disease in MTC. While calcitonin has a linear relationship with disease progression, abnormal CEA levels were a better indicator of advanced disease. CEA levels > 271 ng/ml are significant for advanced tumor size and staging, metastasis to the central compartment, and decreased chance of biochemical cure. CEA levels greater than 500 ng/ml are associated with significant patient mortality.
甲状腺髓样癌（MTC）细胞能够分泌各种肿瘤标志物，包括降钙素和癌胚抗原（CEA）。本研究旨在确定 CEA 水平异常是否可作为肿瘤标志物，预测 MTC 疾病的严重程度。
对术前 CEA 水平升高的 33 例 MTC 患者进行回顾性分析。采用单因素和多因素分析来量化 CEA 水平与肿瘤分期和预后之间的关系。
多因素分析显示，术前 CEA 水平升高与肿瘤大小和分期、远处转移、生化治愈率降低和死亡率显著相关。肿瘤大小>37mm 与 CEA 水平升高（>271ng/ml）显著相关。CEA 水平与癌症分期增加（>377ng/ml）、远处转移（>405ng/ml）和对侧淋巴结转移中央隔室位置（>162ng/ml）也呈正相关。当术前 CEA 水平>500ng/ml 时，患者死亡率为 67%。
在本研究中，术前降钙素和 CEA 水平均与 MTC 疾病的严重程度显著相关。虽然降钙素与疾病进展呈线性关系，但 CEA 水平是晚期疾病的更好指标。CEA 水平>271ng/ml 与肿瘤较大、分期较高、中央隔室转移以及生化治愈率降低显著相关。CEA 水平大于 500ng/ml 与显著的患者死亡率相关。
