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Pre- and Postoperative Levels of Carcinoembryonic Antigen in Microsatellite Stable Versus Instable Colon Cancer: a Retrospective Analysis

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Abstract

Purpose

The prognosis of microsatellite stable (MSS) versus instable (MSI) tumors is an ongoing matter of debate, with differences in expression of carcinoembryonic antigen (CEA) in these two tumor subsets being inconsistently reported to date. The aim of this study was to investigate CEA expression in the context of clinical parameters in MSS and MSI tumors.

Methods

Clinical, pathological, and biochemical parameters of colon cancer patients who underwent curative surgery were documented in a database and compared between MSS and MSI cases. The pre- to postoperative trend of CEA was analyzed. Survival was assessed using the Kaplan–Meier (log rank) test.

Results

One hundred sixty-nine patients were included in the study. Compared to those with MSS tumors, there was a higher proportion of preoperatively elevated CEA among those with MSI tumors (p = 0.067). Median CEA values decreased over the pre- to postoperative course with MSS (p = 0.01) but not MSI (p = 0.093) tumors. The distribution of N classification differed between MSS and MSI tumors (p = 0.014). Patients with MSI tumors had superior survival.

Conclusion

Despite the better prognosis, MSI tumors are associated with increases in CEA. Our findings shed light on discrepancies related to the prognostic evaluation of MSI tumors. Furthermore, in follow-up of colorectal cancers, CEA measurements should be interpreted differently for MSI and MSS tumors.

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Data Availability

The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

CEA:

Carcinoembryonic antigen

CMIA:

Chemiluminescent microparticle immunoassay

CRC:

Colorectal cancer

DNA:

Deoxyribonucleic acid

EPCAM:

Epithelial cell adhesion molecule

IQR:

Interquartile range

MLH-1:

MutL homolog 1

MSH-2:

MutS homolog 2

MSH-6:

MutS homolog 6

PMS-2:

Postmeiotic segregation increased 2

MSI:

Microsatellite instable

MSS:

Microsatellite stable

MMR:

Mismatch repair

SD:

Standard deviation

SPSS:

Statistical Package for the Social Sciences

UICC:

Union for International Cancer Control

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Author information

Authors and Affiliations

  1. Department of Surgery, Barmherzige Brüder Hospital, Spitalgasse 26, 9300, Veit/Glan, Austria

    Diego Andres Salas Campos, Dominik Weihs, Jörg Tschmelitsch & Thomas Eberl

  2. Diagnostic and Research Center for Molecular BioMedicine, Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria

    Cord Langner

  3. Diagnostic and Research Center for Molecular BioMedicine, Diagnostic and Research Institute of Human Genetics, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria

    Jochen Bernd Geigl

Authors
  1. Diego Andres Salas Campos
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  2. Dominik Weihs
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  3. Magdalena Rosenkranz
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  4. Cord Langner
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  5. Jochen Bernd Geigl
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  6. Jörg Tschmelitsch
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  7. Thomas Eberl
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Contributions

Diego Andres Salas Campos produced the datasets from a prospectively maintained database. Dominik Weihs maintained the primary database. Magdalena Rosenkranz performed the statistical analysis and processing of the figures. Cord Langner carried out the pathological assessment, including the molecular analysis. Jochen Bernd Geigl performed the molecular genetic analysis. Jörg Tschmelitsch is head of the department, provided the framework for scientific activity and reviewed the manuscript. Thomas Eberl conceptualized the study and prepared the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Thomas Eberl.

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Competing Interests

The authors declare no competing interests.

Ethics Approval

The study design was approved and consented by the ethics committee of Brothers of Mercy Hospital St. Veit/Glan, reference number 01/2022.

Consent to Participate

Not applicable due to the retrospective character of the study and anonymous processing of the data.

Consent to Publish

Not applicable due to the retrospective character of the study and anonymous processing of the data.

Conflict of Interest

The authors declare no competing interests.

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Salas Campos, D.A., Weihs, D., Rosenkranz, M. et al. Pre- and Postoperative Levels of Carcinoembryonic Antigen in Microsatellite Stable Versus Instable Colon Cancer: a Retrospective Analysis. J Gastrointest Canc 54, 600–605 (2023). https://doi.org/10.1007/s12029-022-00841-z

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  • DOI: https://doi.org/10.1007/s12029-022-00841-z

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