PDF(Pubmed)
Abstract：
Postoperative carcinoembryonic antigen (post-CEA) has recently been reported to be a reliable prognostic factor for colon cancer. However, most clinicians decide whether or not to conduct adjuvant chemotherapy (AC) for stage II colon cancer according to major guidelines, which do not include post-CEA in their high-risk criteria. The present study aimed to assess post-CEA in stage II colon cancer for which the significance of AC is unknown. The present study analyzed 199 consecutive patients with stage II colon cancer who underwent curative surgery between January 2007 and December 2016. The CEA value was considered high when it was ≥5.0 ng/ml. The prognostic value of high post-CEA values was assessed. Overall, 19 patients exhibited high post-CEA levels. Kaplan-Meier survival curve analysis demonstrated that patients with high post-CEA levels had significantly worse relapse-free survival (RFS) and overall survival (OS) than those with normal post-CEA [RFS, 63.5 (high post-CEA) vs. 88.0% (normal post-CEA), P=0.003; OS, 76.5 (high post-CEA) vs. 96.8% (normal post-CEA), P<0.001]. Multivariate analysis demonstrated that high post-CEA remained a significant independent risk factor for worse RFS [hazard ratio (HR), 3.98; P=0.006]. The same was also demonstrated for patients without AC (HR, 5.43; P=0.008). To the best of our knowledge, the present study was the first to demonstrate that high post-CEA levels may be an indicator of high-risk stage II colon cancer, even for patients without AC. These results highlight the need for a multicenter prospective study.
摘要：
最近有报道称，术后癌胚抗原（post-CEA）是结肠癌的可靠预后因素。然而,大多数临床医生根据主要指南决定是否对II期结肠癌进行辅助化疗（AC），其中不包括CEA后的高风险标准。本研究旨在评估CEA后的II期结肠癌，其中AC的意义尚不清楚。本研究分析了在2007年1月至2016年12月期间接受根治性手术的199例II期结肠癌患者。当CEA值≥5.0ng/ml时，它被认为是高的。评估了高CEA后值的预后价值。总的来说,19例患者表现出高的CEA后水平。Kaplan-Meier生存曲线分析表明，CEA后高水平患者的无复发生存率（RFS）和总生存率（OS）明显低于CEA后正常患者[RFS，63.5（CEA后高）与88.0%（正常后CEA），P=0.003;OS,76.5（CEA后高）与96.8%（CEA后正常），P<0.001]。多变量分析表明，高CEA后仍然是RFS恶化的重要独立危险因素[风险比（HR），3.98；P=0.006]。对于没有AC的患者也证明了同样的情况(HR，5.43；P=0.008）。据我们所知,本研究首次证明高CEA后水平可能是高危II期结肠癌的指标，即使对于没有AC的患者。这些结果强调了多中心前瞻性研究的必要性。
