Li Xianzhe, Stassen Lara, Schrotz-King Petra, Zhao Zitong, Cardoso Rafael, Raut Janhavi R, Bhardwaj Megha, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany.
Cancers (Basel). 2023 Nov 30;15(23):5656. doi: 10.3390/cancers15235656.
Carcinoembryonic antigen (CEA) is more abundant in feces than in serum; however, evidence for the role of fecal CEA (FCEA) in the detection of colorectal cancer (CRC) is limited. We conducted a systematic review of studies that evaluated FCEA for the noninvasive detection and diagnosis of CRC. PubMed and Web of Science were searched for relevant studies published until 18 January 2023. Information on publication year, study design, country, study population characteristics, FCEA and serum CEA (SCEA) concentrations, and diagnostic performance was summarized. Two authors independently extracted data and assessed the risk of bias and applicability of each included study. Seven studies published between 1979 and 2021, all conducted in clinical settings and together involving 399 CRC patients and 889 controls, were identified. Significant differences in FCEA concentrations were observed between CRC and control groups in all studies. Methods for detecting FCEA varied, with the electronic chemiluminescence immunoassay (ECLIA) being used in the most recent studies. Reported sensitivities, specificities, and area under the curves of FCEA ranged from 50.0% to 85.7%, 73.0% to 100.0%, and 0.704 to 0.831, respectively. In direct comparisons, the diagnostic performance of FCEA was better than that of SCEA. The potential role of FCEA as a novel, noninvasive, easily measurable biomarker for the diagnosis of CRC requires further evaluation in screening settings.
癌胚抗原(CEA)在粪便中的含量比在血清中更为丰富;然而,粪便癌胚抗原(FCEA)在结直肠癌(CRC)检测中的作用证据有限。我们对评估FCEA用于CRC无创检测和诊断的研究进行了系统评价。检索了PubMed和Web of Science,查找截至2023年1月18日发表的相关研究。总结了有关发表年份、研究设计、国家、研究人群特征、FCEA和血清癌胚抗原(SCEA)浓度以及诊断性能的信息。两位作者独立提取数据,并评估每项纳入研究的偏倚风险和适用性。共识别出1979年至2021年间发表的7项研究,均在临床环境中进行,共纳入399例CRC患者和889例对照。在所有研究中,CRC组和对照组之间观察到FCEA浓度存在显著差异。检测FCEA的方法各不相同,最新研究中使用的是电化学发光免疫分析(ECLIA)。报道的FCEA敏感性、特异性和曲线下面积分别为50.0%至85.7%、73.0%至100.0%和0.704至0.831。在直接比较中,FCEA的诊断性能优于SCEA。FCEA作为一种用于CRC诊断的新型、无创、易于测量的生物标志物的潜在作用,需要在筛查环境中进一步评估。