Preoperative serum CA19-9 should be routinely measured in the colorectal patients with preoperative normal serum CEA : a multicenter retrospective cohort study
© 2022. The Author(s)..
OBJECTIVE: Whether preoperative serum carbohydrate antigen 19-9 (CA19-9) is an independent prognostic factor and there are interactions of serum CA19-9 with carcinoembryonic antigen (CEA) on the risk of recurrence in colorectal cancer (CRC) patients are still not clarified.
METHODS: Consecutive patients with CRC who underwent curative resection for stage II-III colorectal adenocarcinoma at five hospitals were collected. Based on Cox models, associations of preoperative CA19-9 with recurrence-free survival (RFS) and overall survival (OS) were evaluated in patients with or without elevated CEA, and interactions between CEA and CA19-9 were also calculated. Restricted cubic spline (RCS) curves were used to evaluate the associations between preoperative CA19-9 and CRC outcomes on a continuous scale.
RESULTS: A total of 5048 patients (3029 [60.0%] men; median [interquartile range, IQR] age, 61.0 [51.0, 68.0] years; median [IQR] follow-up duration 46.8 [36.5-62.4] months) were included. The risk of recurrence increased with the elevated level of preoperative CA19-9, with the slope steeper in patients with normal CEA than those with elevated CEA. Worse RFS was observed for elevated preoperative CA19-9 (> 37 U/mL) (n = 738) versus normal preoperative CA19-9 (≤ 37 U/mL) (n = 4310) (3-year RFS rate: 59.4% versus 78.0%; unadjusted hazard ratio [HR]: 2.02; 95% confidence interval [CI]:1.79 to 2.28), and significant interaction was found between CA19-9 and CEA (P for interaction = 0.001). Increased risk and interaction with CEA were also observed for OS. In the Cox multivariable analysis, elevated CA19-9 was associated with shorter RFS and OS regardless of preoperative CEA level, even after adjustment for other prognostic factors (HR: 2.08, 95% CI:1.75 to 2.47; HR: 2.25, 95% CI:1.80 to 2.81). Subgroup analyses and sensitivity analyses yielded largely similar results. These associations were maintained in patients with stage II disease (n = 2724).
CONCLUSIONS: Preoperative CA19-9 is an independent prognostic factor in CRC patients. Preoperative CA19-9 can be clinically used as a routine biomarker for CRC patients, especially with preoperative normal serum CEA.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
BMC cancer - 22(2022), 1 vom: 08. Sept., Seite 962 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Li, Zhenhui [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarkers, Tumor |
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| Anmerkungen: |
Date Completed 12.09.2022 Date Revised 13.09.2022 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12885-022-10051-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345932684 |
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| 100 | 1 | |a Li, Zhenhui |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Preoperative serum CA19-9 should be routinely measured in the colorectal patients with preoperative normal serum CEA |b a multicenter retrospective cohort study |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 12.09.2022 | ||
| 500 | |a Date Revised 13.09.2022 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a OBJECTIVE: Whether preoperative serum carbohydrate antigen 19-9 (CA19-9) is an independent prognostic factor and there are interactions of serum CA19-9 with carcinoembryonic antigen (CEA) on the risk of recurrence in colorectal cancer (CRC) patients are still not clarified | ||
| 520 | |a METHODS: Consecutive patients with CRC who underwent curative resection for stage II-III colorectal adenocarcinoma at five hospitals were collected. Based on Cox models, associations of preoperative CA19-9 with recurrence-free survival (RFS) and overall survival (OS) were evaluated in patients with or without elevated CEA, and interactions between CEA and CA19-9 were also calculated. Restricted cubic spline (RCS) curves were used to evaluate the associations between preoperative CA19-9 and CRC outcomes on a continuous scale | ||
| 520 | |a RESULTS: A total of 5048 patients (3029 [60.0%] men; median [interquartile range, IQR] age, 61.0 [51.0, 68.0] years; median [IQR] follow-up duration 46.8 [36.5-62.4] months) were included. The risk of recurrence increased with the elevated level of preoperative CA19-9, with the slope steeper in patients with normal CEA than those with elevated CEA. Worse RFS was observed for elevated preoperative CA19-9 (> 37 U/mL) (n = 738) versus normal preoperative CA19-9 (≤ 37 U/mL) (n = 4310) (3-year RFS rate: 59.4% versus 78.0%; unadjusted hazard ratio [HR]: 2.02; 95% confidence interval [CI]:1.79 to 2.28), and significant interaction was found between CA19-9 and CEA (P for interaction = 0.001). Increased risk and interaction with CEA were also observed for OS. In the Cox multivariable analysis, elevated CA19-9 was associated with shorter RFS and OS regardless of preoperative CEA level, even after adjustment for other prognostic factors (HR: 2.08, 95% CI:1.75 to 2.47; HR: 2.25, 95% CI:1.80 to 2.81). Subgroup analyses and sensitivity analyses yielded largely similar results. These associations were maintained in patients with stage II disease (n = 2724) | ||
| 520 | |a CONCLUSIONS: Preoperative CA19-9 is an independent prognostic factor in CRC patients. Preoperative CA19-9 can be clinically used as a routine biomarker for CRC patients, especially with preoperative normal serum CEA | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a CA19-9 | |
| 650 | 4 | |a CEA | |
| 650 | 4 | |a Colorectal cancer | |
| 650 | 4 | |a Interaction | |
| 650 | 7 | |a Biomarkers, Tumor |2 NLM | |
| 650 | 7 | |a CA-19-9 Antigen |2 NLM | |
| 650 | 7 | |a Carcinoembryonic Antigen |2 NLM | |
| 700 | 1 | |a Zhu, Haibin |e verfasserin |4 aut | |
| 700 | 1 | |a Pang, Xiaolin |e verfasserin |4 aut | |
| 700 | 1 | |a Mao, Yun |e verfasserin |4 aut | |
| 700 | 1 | |a Yi, Xiaoping |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Chunxia |e verfasserin |4 aut | |
| 700 | 1 | |a Lei, Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Xianshuo |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Lei |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Jiamei |e verfasserin |4 aut | |
| 700 | 1 | |a Ding, Yingying |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Yingshi |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Tao |e verfasserin |4 aut | |
| 700 | 1 | |a You, Dingyun |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Zaiyi |e verfasserin |4 aut | |
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