ABSTRACT
Objective:To explore the value of tumor diameter to preoperative carcinoembryonic antigen (CEA) ratio (TCR) in predicting prognosis of patients with non-metastatic colorectal cancer.Methods:The clinical data of 144 patients with colorectal cancer in Hainan Hospital of PLA General Hospital between July 2012 and December 2017 were retrospectively analyzed. Patients were divided into the low TCR group and the high TCR group according to the optimal value of TCR in predicting the disease-free survival (DFS) determined by the receiver operating characteristic curve (ROC). The clinicopathological features of both groups were analyzed, and the influencing factors of DFS were also analyzed by using Cox proportional hazard model.Results:ROC analysis showed that TCR had a certain value in predicting DFS, and area under the curve (AUC) was 0.614 (95% CI 0.507-0.722); when the value of TCR was set at 0.690, the sensitivity and specificity of predicting the 3-year DFS rate was 46.3% and 70.9%, respectively. According to 0.690 of TCR, there were 50 cases in the low TCR (< 0.690) group and 94 cases in the high TCR (≥0.690) group. There were no statistically significant differences in the high and low TCR between the two groups for patients stratified by gender, age, tumor location, differentiation degree, invasive depth, lymph node metastasis, TNM stage (all P > 0.05). Univariate analysis showed that TCR, preoperative CEA level and TNM stage played a role in predicting DFS of patients (all P < 0.05), while Cox multivariate analysis indicated that TCR < 0.690 ( HR = 2.369, 95% CI 1.279-4.388, P = 0.006) and Ⅲ stage in TNM stage ( HR = 2.214, 95% CI 1.346-3.640, P = 0.002) were the independent risk factors of influencing DFS (all P < 0.01). The 3-year DFS rate of patients in the low TCR group was lower than that of those in the high TCR group (62.0% vs. 83.0%, P = 0.007). Conclusion:TCR could have a certain value in judging the prognosis of non-metastatic colorectal cancer patients, and low TCR patients have a poorer prognosis.
ABSTRACT
Objective To evaluate the prognostic value of combined examination of pre-operative carcinoembryonic antigen (CEA) and CD44v6 for colorectal cancer patients. Methods A total of 140 patients with complete clinical data pathologically diagnosed as colorectal cancer from December 2012 to December 2017 in Hainan Hospital of PLA General Hospital were enrolled. Finally, 69 validated cases excluding CEA (-) or CD44v6(-) patients were registered according to pre-operative CEA detection and immunohistochemistry results of CD44v6. Kaplan-Meier method was used to analyze the progression-free survival (PFS) time for single factors. Multiple-factor analysis was done by using Cox proportional hazard model. Results Sixty-nine patients included 29 cases of double positive and 40 cases of double negative in CEA and CD44v6. There were statistical significances of the expressions of double positive and double negative in patients with different gender, M stage, TNM stage. Double positive was more apparent in female (χ2 = 4.42, P= 0.04), presenting of metastasis (χ2=5.06, P=0.02) and advanced cases (χ2=4.38, P= 0.04); univariable analysis showed the N stage (P=0.00), M stage (P=0.00), TNM stage (P=0.00) and double positive/double negative in CEA and CD44v6 (P= 0.04) were likely to affect the PFS, however, multivariable analysis showed that N stage (HR= 0.15, 95 ％ CI: 0.03-0.86, P= 0.03), TNM stage (HR= 23.83, 95 ％ CI: 3.65-155.51, P=0.00) were the independent prognostic factors for PFS. PFS in double positive patients was shorter than that in double negative ones [24.0 months (3-84) vs. 31.0 months (8-94), P=0.04]. Conclusion Pre-operative combined examination of CEA and CD44v6 could be helpful in judging the prognosis for colorectal cancer patients.