| Lili Shen,Chao Li,Jingwen Wang,Jin Fan,Ji Zhu. CEA levels predict tumor response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Oncol Transl Med, 2022, 8: 180-185. |
| CEA表达水平预测局部进展期直肠癌对新辅助放化疗的反应 |
| CEA levels predict tumor response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer |
| Received:January 05, 2022 Revised:July 30, 2022 |
| DOI：10.1007/s10330-022-0548-8 |
| 中文关键词: 局部进展期直肠癌; 癌胚抗原; 新辅助放化疗; 病理完全缓解 |
| 英文关键词: locally advanced rectal cancer (LARC); carcinoembryonic antigen (CEA); neoadjuvant chemoradiotherapy; pathological complete response (pCR) |
| 基金项目:南通市卫生健康委员会科研课题（编号：QA2019049） |
| Author Name | Affiliation | E-mail | | Lili Shen* | Department of Oncology, Nantong Haimen People’s Hospital, Haimen Hospital of Nantong University | shenlilimao2012@163.com | | Chao Li | Department of Radiotherapy, Huashan Hospital, Fudan University | | | Jingwen Wang | Department of Radiation Oncology, Fudan University Shanghai Cancer Center | | | Jin Fan | Department of Radiation Oncology, Fudan University Shanghai Cancer Center | | | Ji Zhu | Department of Radiation Oncology, Fudan University Shanghai Cancer Center | |
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| 中文摘要: |
| 目的：评价血清癌胚抗原(CEA)对预测局部进展期直肠癌(LARC)新辅助放化疗(nCRT)的患者病理完全缓解(pCR)状态的作用。
方法：选取2006年3月至2018年2月期间，在复旦大学附属肿瘤医院，接受nCRT和TME治疗的LARC患者925名。我们使用logistic回归模型分别研究了血清CEA水平(包括nCRT前和nCRT后CEA水平)与病理完全缓解(pCR)之间的关系，并根据不同CEA临界值进行分层分析。?
结果：我们发现nCRT前和nCRT后CEA均与pCR呈负相关(p < 0.001)。?分层分析发现，当CEA临界值设置为5 ng/ml时，nCRT后CEA水平为> 5 ng/ml的患者中，有10.6%的达到pCR。?同时，当CEA临界值设置为10 ng/ml时，nCRT后CEA水平> 10 ng/ml的患者中只有6.8%的人达到pCR。 ?
结论：总之，在LACR患者中，nCRT前和nCRT后的CEA水平≤5 ng/mL是pCR的良好预测指标，对于nCRT后CEA水平> 10 ng/mL的患者不建议采用“观察和等待”策略。 |
| 英文摘要: |
| Objective The aim of this study was to evaluate the impact of serum carcinoembryonic antigen (CEA) in
the prediction of pathological complete response (pCR) in locally advanced rectal cancer (LARC) patients
treated with neoadjuvant chemoradiotherapy (nCRT).
Methods A total of 925 LARC patients who underwent nCRT followed by TME between March 2006
and February 2018 were enrolled at Fudan University Shanghai Cancer Center. Using logistic regression
models, we investigated the associations between serum CEA levels and pathological complete remission
(pCR). Further stratified analyses were performed according to different CEA thresholds.
Results We found that pre-nCRT CEA and post-nCRT CEA were negatively correlated with pCR
(P < 0.001). Stratified analyses revealed that when the CEA cutoff value was set to 5 ng/mL, 10.6% of
patients with post-nCRT CEA levels > 5 ng/mL achieved pCR. Meanwhile, when the CEA cutoff value was
set to 10 ng/mL, only 6.8% of the patients with post-nCRT CEA levels > 10 ng/mL achieved pCR.
Conclusion In summary, pre- and post-nCRT CEA levels ≤ 5 ng/mL were favorable predictors of pCR
in LACR patients, and the “watch and wait” strategy is not recommended for patients with post-nCRT CEA
levels > 10 ng/mL. |
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