Objective:To investigate whether increased levels of preoperative carcinoembryonic antigen (CEA) and CA199 were associated with the mortality of patients with advanced colorectal cancer and to determine whether CA199 can be used to discriminate patients with normal preoperative CEA level from good to poor prognosis. Methods:A total of 314 patients with advanced colorectal cancer cases who underwent primary tumor resection were collected from 2014 to 2016 at Peking University Cancer Hospital and Institute. Preoperative CEA and CA199 serum levels were examined using electrochemiluminescence immunoassay. The association of CEA and CA199 with clinicopathologic features and their possible prognostic values were analyzed. Results:In the tested patients, 5.4%of whom had increased CA199 level but not up-regulated CEA level, whereas 28.3%only had increased CEA level, and 21.3%had both CEA and CA199 levels increased. Kaplan-Meier survival curves indicated that patients with elevated preoperative CEA level had worse disease-free survival (DFS) and overall survival (OS) than those with normal CEA (P<0.001 and P<0.001, respectively). Meanwhile, patients with elevated CA199 level had worse DFS and OS than those with normal CA199 (P<0.001 and P<0.001, respectively). Preoperative CA199 level could be used in discriminating patients with normal CEA from good to poor prognosis (P=0.012). Multivariate analysis revealed that elevated CA199 level was an independent prognostic factor for OS in patients with advanced colorectal cancer (HR=2.025, 95%CI=1.331-3.082, P=0.001). Conclusion:Combined detection of preoperative CEA and CA199 can be used in evaluating the prognosis of patients with advanced colorectal cancer. Preoperative serum CA199 level can be used in evaluating the prognosis of patients with colorectal cancer without an increase in CEA level. Patients with increased CA199 level had worse 5-year survival than those with increased CEA level.

OBJECTIVETo explore the expression of NF-E1b in colorectal cancer tissues and its association with various clinicopathological parameters and prognosis of the patients.

METHODSClinicopathological and follow-up data of 168 colorectal cancer patients undergoing radical operation at Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute from 2005 to 2012 were retrospectively analyzed, including 96 males and 72 females, with mean age of (57.8±11.2) years. The expression of NF-E1b protein was detected in samples of 168 resected colorectal cancer tissues and 45 adjacent non-cancerous tissues by immunohistochemistry. The expression rates of NF-E1b were compared among different clinicopathological features. Moreover, the association between NF-E1b expression and prognosis was analyzed.

RESULTSThe expression of NF-E1b protein located mainly in cytoplasm. Positive rate of NF-E1b expression in adjacent non-cancerous tissues was 17.8% (8/45), which was obviously lower than 67.9%(114/168) of cancer tissues with significant difference (χ(2)=36.376, P=0.000). Clinicopathological parameters analysis suggested that the expression level of NF-E1b in cancer tissues was associated with age (χ(2)=4.862, P=0.030), TNM staging (χ(2)=10.969, P=0.002), lymph node metastasis (χ(2)=7.390, P=0.008) and distal metastasis (χ(2)=17.887, P=0.000). The median follow-up time was 23(1-77) months. The overall 5-year survival of this cohort was 33.3%. Colorectal cancer patients with high levels of NF-E1b expression showed a worse overall survival compared with those with low levels of NF-E1b expression (18.4% vs. 56.6%, P=0.000). Univariate Cox regression analysis showed that tumor location (P=0.034), tumor size (P=0.003), TNM staging (P=0.000), depth of tumor invasion (P=0.009), lymph node metastasis (P=0.000), distant metastasis (P=0.000) and NF-E1b expression level (P=0.001) were associated with the prognosis of colorectal cancer patients. Multivariate Cox regression analysis revealed that tumor diameter >4 cm (HR=2.193,95% CI:1.334 to 3.603, P=0.002), distant metastasis (HR=2.064, 95% CI:1.160 to 3.672, P=0.014) and high NF-E1b expression (HR=1.994,95% CI:1.068 to 3.724, P=0.030) were independent risk factors of predicting poor prognosis of colorectal cancer patients.

CONCLUSIONSNF-E1b expression up-regulates in colorectal cancer tissues. High expression of NF-E1b is associated with poor prognosis of colorectal cancer patients. NF-E1b may serve as a potential target of the treatment for colorectal cancer.

Aged ; Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; diagnosis ; metabolism ; Digestive System Surgical Procedures ; Female ; GATA2 Transcription Factor ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Risk Factors ; Up-Regulation

OBJECTIVETo investigate the predictive value of preoperative detection of CEA and CA199 for prognosis in patients with stage II-III colorectal cancer (CRC).

METHODSClinicopathological and follow-up data of 266 patients with stage II-III colorectal cancer confirmed by pathology and undergoing radical resection in our department from 2004 to 2006 were retrospectively analyzed. The 5-year overall survival (OS) and disease-free survival (DFS) between normal CEA patients and increased CEA ones, and normal CA199 patients and increased CA199 ones were compared respectively. Moreover, the risk factors of OS and DFS were examined.

RESULTSAmong these 266 patients, 119 (44.7%) had preoperative elevated CEA, and 74 (27.8%) had increased CA199. The median follow-up time was 63 months. Kaplan-Meier survival curves indicated that patients with elevated preoperative CEA had worse 5-year OS (54.6% vs. 72.8%, P=0.001) and DFS (75.2% vs. 83.3%, P=0.042) than those with normal CEA respectively. Meanwhile, patients with elevated CA199 had worse OS (45.9% vs. 71.9%, P=0.000) and DFS (74.2% vs. 81.8%, P=0.047) than those with normal CA199 respectively. Multivariate analysis revealed that male (HR=3.016, 95% CI: 1.536-5.919, P=0.001), lymph node metastasis (HR=2.278, 95% CI: 1.272-4.081, P=0.006), and preoperative elevated CEA (HR=1.794, 95%CI: 1.022-3.149, P=0.042) were independent prognostic factors of DFS. While vascular thrombosis (HR=2.041, 95% CI: 1.294-3.221, P=0.002), lymph node metastasis (HR=2.480, 95% CI:1.548-3.972, P=0.000), and preoperative elevated CA199 (HR=2.145, 95% CI:1.414-3.254, P=0.000) were independent prognostic factors of OS in patients with stage II-III CRC.

CONCLUSIONCombined detection of preoperative CEA and CA199 can be used in evaluating the prognosis of patients with stage II-III CRC.

Antigens, Tumor-Associated, Carbohydrate ; blood ; Carcinoembryonic Antigen ; blood ; Colorectal Neoplasms ; diagnosis ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Male ; Multivariate Analysis ; Neoplasm Staging ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate