J Korean Surg Soc.  2011 Dec;81(6):387-393. 10.4174/jkss.2011.81.6.387.

Carcinoembryonic antigen level of draining venous blood as a predictor of recurrence in colorectal cancer patient

• Lee SY
• Min KS
• Chung JK
• Jung IM
• Ahn YJ
• Hwang KT
• Ahn HS
• Heo SC

• KMID: 1445767
• DOI: http://doi.org/10.4174/jkss.2011.81.6.387

Abstract

PURPOSE
We designed this study to evaluate the efficacy of carcinoembryonic antigen in draining venous blood (vCEA) as a predictor of recurrence.
METHODS
Draining venous and supplying arterial bloods were collected separately during the operation of 82 colorectal cancer patients without distant metastasis from September 2004 to December 2006. Carcinoembryonic antigen was measured and assessed for the efficacy as a prognostic factor of recurrence using receiver operating characteristic (ROC) and Kaplan-Meier curves.
RESULTS
vCEA is a statistically significant factor that predicts recurrence (P = 0.032) and the optimal cut-off value for vCEA from ROC curve is 8.0 ng/mL. The recurrence-free survival between patients with vCEA levels >8 ng/mL and < or =8 ng/mL significantly differed (P < 0.001). The significance of vCEA as a predictor of recurrence gets higher when limited to patients without lymph node metastasis. The proper cut-off value for vCEA is 4.0 ng/mL if confined to patients without lymph node metastasis. The recurrence-free survival between the patients of vCEA levels >4 ng/mL and < or =4 ng/mL significantly differed (P < 0.001). Multivariate analysis revealed vCEA is an independent prognostic factor in patients without lymph node metastasis.
CONCLUSION
vCEA is an independent prognostic factor of recurrence in colorectal cancer patients especially in patients without lymph node metastases.

Keyword

Colorectal neoplasms; Carcinoembryonic antigen; Prognosis; Recurrence

MeSH Terms

Carcinoembryonic Antigen
Colorectal Neoplasms
Humans
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Prognosis
Recurrence
ROC Curve
Carcinoembryonic Antigen

Figure

• 

  Fig. 1 Efficacy of vCEA as a predictor of recurrence. ROC curve shows that vCEA is a statistically significant factor that predicts recurrence (A). There are significant differences in recurrence-free survival between high vCEA group and low vCEA group (B). aCEA, feeding anterial blood CEA; vCEA, draining venous blood CEA; vaCEA, difference between vCEA and aCEA (vCEA-aCEA); ROC, receiver operating characteristic.

• 

  Fig. 2 Recurrence-free survivals between high vCEA group and low vCEA group stratified by lymph node (LN) metastasis. There are significant differences in recurrence-free survival between two groups if the patient has no LN metastasis (A), but not if the patient has LN metastasis (B). vCEA, draining venous blood CEA.

• 

  Fig. 3 The efficacy of vCEA as a predictor of recurrence in patients without lymph node (LN) metastasis. ROC curve shows that vCEA is a more reliable prognostic factor when confined to patients without LN metastasis (A). There are significant differences in recurrence-free survival between high vCEA group and low vCEA group (B). vCEA, draining venous blood CEA; ROC, receiver operating characteristic.

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