The prognostic significance of CEA in patients with simultaneous liver and/or lung metastasis of colon cancer and the establishment of a nomogram: a study based on the SEER database
10.3760/cma.j.cn431274-20221129-01239
- VernacularTitle:CEA在结肠癌伴同时性肝和(或)肺转移患者中的预后意义及normogram图的建立：基于SEER数据库的研究
- Author:
Junsong LIU
1
;
Zhilong LI
;
Lanping SHI
;
Hongzhuan YIN
Author Information
1. 中国医科大学研究生联合培养基地辽宁省健康产业集团抚矿总医院普外科，抚顺 113000
- Keywords:
Carcinoembryonic antigen;
Colonic neoplasms;
Liver metastasis;
Lung metastasis;
Nomograms
- From:
Journal of Chinese Physician
2023;25(9):1363-1368
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognostic significance of preoperative carcinoembryonic antigen (CEA) in patients with stage Ⅳ colon cancer with simultaneous liver and/or lung metastasis, and establish a predictive model.Methods:Using the SEER database, 5 149 patients diagnosed with colon cancer from 2010 to 2015 were collected based on inclusion and exclusion criteria. They were divided into a CEA positive group and a CEA negative group based on their preoperative CEA status. Based on the different CEA status and metastatic sites, we plotted different survival curves and analyzed the differences using the Log rank method. We used the Cox proportional risk model to analyze the risk factors affecting the prognosis of patients with simultaneous liver and/or lung metastasis in colon cancer, and constructed a column chart based on the results. The area under the receiver operating characteristic (ROC) curve of different variable models was calculated and the model discrimination wasevaluated. By using x-tile software, the optimal cutoff value for individual total scores was selected and risk levels were classified to predict patient prognosis.Results:CEA positive colon cancer patients with liver and/or lung metastasis had a poor prognosis, with a 5-year survival rate of 13.4%. Cox proportional risk analysis showed that CEA positive patients had an increased risk of death compared to negative patients after adjusting for other factors ( HR=1.64). After incorporating the CEA+ X, X (independent risk factors other than CEA), and AJCC T+ N models, the areas under the ROC curve were 0.712, 0.706, and 0.59, respectively. According to the prediction score given in the column chart, the x-tilie selected for the best cutoff score was 262.5, which can be divided into high-risk and low-risk populations. The Log rank test was P<0.05. Conclusions:The preoperative CEA level has important predictive value for the prognosis of stage IV colon cancer patients with simultaneous liver and/or lung metastasis. The survival prediction model and column chart for colorectal cancer patients with liver and/or lung metastasis established based on the Cox proportional risk model are of great significance for patient prognosis evaluation and are conducive to the selection of personalized treatment plans.
