Combined preoperative CEA and CD44v6 improves prognostic value in patients with stage I and stage II colorectal cancer
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Combination of biomarkers may improve diagnosis and have better prognostic value than single markers. The purpose of this study was to investigate whether combined CEA and CD44v6 improves prognostic value in stage I and stage II (stage I/II) colorectal cancer (CRC).
Preoperative serum CEA level and the expression of CD44v6 in CRC tissues were examined by electrochemiluminescence immunoassay and immunohistochemistry, respectively. The association of CEA and CD44v6 with clinicopathological features and their possible prognostic values was analyzed.
The preoperative elevated serum CEA level and positive CD44v6 expression were detected in 30.1 % (52/173) serum samples and 60.5 % (101/167) CRC tissues, respectively. Patients with an elevated-CEA level or a CD44v6-negative tumor had a worse disease-specific survival (DSS) than those with a normal-CEA level or CD44v6-positive tumor (P = 0.024, P = 0.012, respectively). Moreover, CD44v6 expression could be used in discriminating patients from good to poor prognosis in normal-CEA subgroup (P = 0.043), but not in elevated-CEA subgroup (P = 0.563). Multivariate analysis revealed that combined CEA and CD44v6 was an independent prognostic factor for patients with stage I/II CRC (P = 0.023). However, serum CEA level only retained a borderline significance for correlation with a worse DSS (P = 0.059), and CD44v6 expression alone was not an independent prognostic factor for DSS in multivariate analysis (P = 0.123).
These results suggested that combined CEA/CD44v6 had better prognostic value than CEA or CD44v6 alone for patients with stage I/II CRC.
KeywordsCEA CD44v6 Colorectal cancer Prognosis
We thank Dr. Li Sun and Yiqiang Liu for histopathological diagnosis. We thank Dr. Jiabo Di for critical reading of the manuscript. This study was supported by the grants from the National Natural Science Foundation of China (No. 81272766 and No. 81071658), Capital Medical Development and Research Foundation (No. 2009-2093), Clinical Characteristics and Application Research of Capital (Beijing Municipal Science & Technology Commission No. Z121107001012130), Beijing Natural Science Foundation (No. 7132054), New Star of Science and Technology Program of Beijing (Beijing Municipal Science & Technology Commission No. 2011060).
Conflict of interest
The authors declare that they have no conflict of interest.
- 11.López-Gómez M, Casado E, Cejas P, Feliu J. Prognostic and predictive factors in colorectal cancer: The importance of reliable markers for effective selection of therapy. In: Esther Uña Cidón editor. The challenge of colorectal cancer: a review book. India: Research Signpost Press; 2011. p. 285–308.Google Scholar
- 19.Sun LC, Chu KS, Cheng SC, Lu CY, Kuo CH, Hsieh JS, et al. Preoperative serum carcinoembryonic antigen, albumin and age are supplementary to UICC staging systems in predicting survival for colorectal cancer patients undergoing surgical treatment. BMC Cancer. 2009;9:288.PubMedCentralPubMedCrossRefGoogle Scholar
- 22.Fakih MG, Padmanabhan A. CEA monitoring in colorectal cancer. What you should know. Oncology (Williston Park). 2006;20:579–87.Google Scholar