Individualized Cutoff Value of the Preoperative Carcinoembryonic Antigen Level is Necessary for Optimal Use as a Prognostic Marker
Jeon Byeong-Geon, 신루미, 정중기, 정인묵, 허승철,
소속 상세정보
( Jeon Byeong-Geon )
Seoul National University Hospital Department of Surgery
신루미 ( Shin Ru-Mi )
SMG-SNU Boramae Medical Center Department of Surgery
정중기 ( Chung Jung-Kee )
SMG-SNU Boramae Medical Center Department of Surgery
정인묵 ( Jung In-Mok )
SMG-SNU Boramae Medical Center Department of Surgery
허승철 ( Heo Seung-Chul )
SMG-SNU Boramae Medical Center Department of Surgery
KMID : 0356720130290030106
Abstract
Purpose: Carcinoembryonic antigen (CEA) is an important prognostic marker in colorectal cancer (CRC). However, in some stages, it does not work. We performed this study to find a way in which preoperative CEA could be used as a constant prognostic marker in harmony with the TNM staging system.
Methods: Preoperative CEA levels and recurrences in CRC were surveyed. The distribution of CEA levels and the recurrences in each TNM stage of CRC were analyzed. An optimal cutoff value for each TNM stage was calculated and tested for validity as a prognostic marker within the TNM staging system.
Results: The conventional cutoff value of CEA (5 ng/mL) was an independent prognostic factor on the whole. However, when evaluated in subgroups, it was not a prognostic factor in stage I or stage III of N2. A subgroup analysis according to TNM stage revealed different CEA distributions and recurrence rates corresponding to different CEA ranges. The mean CEA levels were higher in advanced stages. In addition, the recurrence rates of corresponding CEA ranges were higher in advanced stages. Optimal cutoff values from the receiver operating characteristic curves were 7.4, 5.5, and 4.5 ng/mL for TNM stage I, II, and III, respectively. Those for N0, N1, and N2 stages were 5.5, 4.8, and 3.5 ng/mL, respectively. The 5-year disease-free survivals were significantly different according to these cutoff values for each TNM and N stage. The multivariate analysis confirmed the new cutoff values to be more efficient in discriminating the prognosis in the subgroups of the TNM stages.
Conclusion: Individualized cutoff values of the preoperative CEA level are a more practical prognostic marker following and in harmony with the TNM staging system.
키워드
Carcinoembryonic antigen;Colorectal neoplasms;Prognosis;TNM Staging;Cutoff value
원문 및 링크아웃 정보
등재저널 정보