Tang Fan, Huang Cheng-Wen, Tang Zhi-Hong, Lu Shao-Long, Bai Tao, Huang Qing, Li Xing-Zhi, Zhang Bin, Wu Fei-Xiang
Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Key Laboratory of High-Incidence-Tumor Prevention & Treatment, Ministry of Education, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
World J Gastrointest Surg. 2023 Dec 27;15(12):2890-2906. doi: 10.4240/wjgs.v15.i12.2890.
Carcinoembryonic antigen (CEA) is a broad-spectrum tumor marker for differential diagnosis, monitoring, and response assessment of a variety of malignancies.
To evaluate whether serum CEA could predict the prognosis in patients with colorectal cancer liver metastasis (CRCLM) before and after liver resection (LR).
PubMed, Embase, Cochrane, and Web of Science were systematically searched to retrieve literature, with a search cut-off date of February 27, 2023. Articles were strictly screened for inclusion according to pre-specified inclusion and exclusion criteria. Data were pooled and analyzed using Stata 16.0.
This meta-analysis included 36 studies involving a total of 11143 CRCLM patients. The results showed that a high pre-LR serum CEA level was correlated with poor overall survival (OS) [hazard ratio (HR) = 1.61, 95% confidence interval (CI): 1.49-1.75, < 0.001] and recurrence-free survival (HR = 1.27, 95%CI: 1.11-1.45, < 0.001) in CRCLM patients. A high post-LR serum CEA level predicted poor OS (HR = 2.66, 95%CI: 2.10-3.38, < 0.001). A comparison by treatment modality, analysis modality, patient source, and cutoff-value showed that overall, high preoperative and postoperative serum CEA levels remained correlated with a poor prognosis.
This study concluded that high pre-LR and post-LR serum CEA levels were significantly correlated with a poor prognosis in CRCLM patients.
癌胚抗原（CEA）是一种用于多种恶性肿瘤鉴别诊断、监测及疗效评估的广谱肿瘤标志物。
评估血清CEA能否预测结直肠癌肝转移（CRCLM）患者肝切除（LR）前后的预后。
系统检索PubMed、Embase、Cochrane和Web of Science以获取文献，检索截止日期为2023年2月27日。根据预先设定的纳入和排除标准严格筛选纳入文章。使用Stata 16.0对数据进行汇总和分析。
本荟萃分析纳入36项研究，共11143例CRCLM患者。结果显示，LR前血清CEA水平高与CRCLM患者的总生存期（OS）差相关[风险比（HR）=1.61，95%置信区间（CI）：1.49 - 1.75，P<0.001]及无复发生存期（HR = 1.27，95%CI：1.11 - 1.45，P<0.001）。LR后血清CEA水平高预示OS差（HR = 2.66，95%CI：2.10 - 3.38，P<0.001）。按治疗方式、分析方式、患者来源和临界值进行比较，结果显示总体而言，术前和术后血清CEA水平高仍与预后差相关。
本研究得出结论，LR前后血清CEA水平高与CRCLM患者预后差显著相关。
