The difference in prognosis of stage II and III colorectal cancer based on preoperative serum tumor markers

ObjectivesTo assess the association between common-used serum tumor markers and recurrence of lung adenocarcinoma and squamous cell carcinoma separately and determine the prognostic value of serum tumor markers in lung adenocarcinoma featured as ground glass opacities.MethodsA total of 2,654 non-small cell lung cancer patients undergoing surgical resection between January 2008 and September 2014 were analyzed. The serum levels of carcinoma embryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153) and carbohydrate antigen 199 (CA199) were tested preoperatively. Survival analyses were performed with COX proportional hazard regression.ResultsAmong patients with lung adenocarcinoma, elevated preoperative serum CEA(HR=1.246, 95%CI:1.043-1.488, P=0.015), CYFRA21-1(HR=1.209, 95%CI:1.015-1.441, P=0.034) and CA125(HR=1.361, 95%CI:1.053-1.757, P=0.018) were significantly associated with poorer recurrence free survival (RFS). Elevated preoperative serum CA199 predicted worse RFS in patients diagnosed with lung squamous cell carcinoma (HR=1.833, 95%CI: 1.216-2.762, P=0.004). Preoperative serum CYFRA21-1(HR=1.256, 95%CI:1.044-1.512, P=0.016) and CA125(HR=1.373, 95%CI: 1.050-1.795, P=0.020) were independent prognostic factors for patients with adenocarcinoma presenting as solid nodules while serum CEA (HR=2.160,95%CI:1.311-3.558, P=0.003) and CA125(HR=2.475,95%CI:1.163-5.266, P=0.019) were independent prognostic factors for patients with adenocarcinoma featured as ground glass opacities.ConclusionsThe prognostic significances of preoperative serum tumor markers in non-small cell lung cancer were associated with radiological features and histological types.

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Construction of a Lymph Node Metastasis Nomogram Prediction Model Based on Dual-Energy CT Radiomics of Gastric Cancer Lesions

10.21203/rs.3.rs-510637/v1 ◽

2021 ◽

Author(s):

Hong-li CUN ◽

Qian-ting DUAN ◽

Ying-ying DING ◽

Da-fu Zhang ◽

Ling YANG ◽

...

Keyword(s):

Gastric Cancer ◽

Tumor Markers ◽

Iodine Concentration ◽

Dual Energy ◽

Dual Energy Ct ◽

Test Set ◽

Serum Tumor Markers ◽

Node Metastasis ◽

Preoperative Serum ◽

Auc Value

Abstract Background This study aimed to explore the value of gastric cancer (GC) tumor markers and dual-energy CT（DECT） scans of arterial and venous GC lesions with quantitative iodine concentration (IC) and radiomics, to predict lymph node metastasis (LNM) in patients with GC. Methods This prospective study comprised of 177 patients that underwent dual-energy CT scans before surgery, and were subsequently diagnosed with GC by postoperative pathology. Serum tumor markers and arterial phases (AP) and venous phases (VP) of GC lesion iodine concentration (IC) and normalized iodine concentration (nIC) were analyzed. Patients were divided into either the LNM group or non-LNM group according to pathological results. The Wilcoxon rank-sum test was used to compare the serum tumor markers, IC, and nIC of the 2 groups, and a ROC curve was drawn to evaluate their effectiveness in predicting LNM in patients with GC. After using the Siemens syngo.via Frontier Radiomics software to extract radiomics features , all patients were randomly divided into a train set and a test set with a 7:3 ratio to predict GC LNM. Results Among the 177 patients with GC, 83 were diagnosed with LNM, while 94 did not have LNM. The preoperative serum tumor markers CA125, CA199, and CEA were statistically significant for predicting the presence of LNM (P<0.05). In the transfer group, AP and VP IC were 2.63 mg/ml (2.3, 3.00) and 3.60 mg/ml (3.23, 4.03) respectively, with corresponding areas under the curve (AUC) of 0.83 and 0.91. The nIC was 0.18 mg/ml (0.15, 0.21) and 0.78 mg/ml (0.65, 0.86); the AUC curve was 0.79 and 0.87. Both the IC and nIC were higher in the patients with LNM than those without LNM (P<0.05). Establishing a random forest (RF) model based on the radiomics extracted from the GC lesions had a high diagnostic value in predicting whether the lymph nodes in patients with GC were metastatic. The RF model AUC value was 0.959 for the train set and 0.977 for the test set. The AUC value of the nomogram predicting LNM was 0.996 for the train set and 0.976 for the test set. Conclusion Models based on preoperative serum tumor markers (CA125, CA199, and CEA) in patients with GC, quantitative dual-energy CT parameter values of the lesions (AP and VP IC, nIC), and radiomics have a higher diagnosis of LNM. The value of nomogram in combination with multi-parameter analysis is higher diagnosis of LNM, which can provide a reliable basis for preoperative evaluation of LNM.

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Serum Tumor Markers Combined With Clinicopathological Characteristics for Predicting MMR and KRAS Status in 2279 Chinese Colorectal Cancer Patients: A Retrospective Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.582244 ◽

2021 ◽

Vol 11 ◽

Author(s):

Ning Zhao ◽

Yinghao Cao ◽

Jia Yang ◽

Hang Li ◽

Ke Wu ◽

...

Keyword(s):

Colorectal Cancer ◽

Retrospective Analysis ◽

Tumor Markers ◽

Clinicopathological Characteristics ◽

Right Colon ◽

Independent Predictive Factor ◽

Kras Mutations ◽

Serum Tumor Markers ◽

The Status ◽

Colorectal Cancer Patients

Although serum tumor markers (STMs), clinicopathological characteristics and the status of KRAS and MMR play an important role in optimizing the treatment and prognosis of colorectal cancer, their interrelationships remain largely unknown. A retrospective analysis of 2279 patients who tested for KRAS and MMR status, and STM measurements prior to treatment over the past four years was conducted. Of the 784 patients tested for KRAS and 2279 patients tested for MMR status, KRAS mutations and dMMR were identified in 276 patients (35.20%) and 177 patients (7.77%), respectively. Logistic regression analysis demonstrated that right colon, well and moderate differentiation and negative CA19-9 were independent predictors for KRAS mutations. The ROC curve yielded an AUC of 0.609 through the combination of these three factors. Age < 65 was an independent predictive factor for dMMR, along with tumor size > 4.6 cm, right colon, poor differentiation, harvested lymph nodes ≥ 22, no lymph node metastasis, no perineural invasion, negative CEA and positive CA72-4. When the nine criteria were used together, the AUC was 0.849. In summary, both STMs and clinicopathological characteristics were found to be significantly associated with the status of KRAS and MMR. The combination of these two factors possessed a strong predictive power for KRAS mutations and dMMR among CRC patients.

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Comparison of Serum Tumor Markers for Intrahepatic Cholangiocarcinoma and Hepatocellular Carcinoma

The American Surgeon ◽

10.1177/000313481007601119 ◽

2010 ◽

Vol 76 (11) ◽

pp. 1210-1213 ◽

Cited By ~ 21

Author(s):

Lian-Yuan Tao ◽

Lei Cai ◽

Xiao-Dong He ◽

Wei Liu ◽

Qiang Qu

Keyword(s):

Hepatocellular Carcinoma ◽

Carcinoembryonic Antigen ◽

Tumor Markers ◽

Intrahepatic Cholangiocarcinoma ◽

High Specificity ◽

Serum Levels ◽

Diagnostic Value ◽

Carbohydrate Antigen ◽

Serum Tumor Markers ◽

Preoperative Serum

Serum tumor markers such as alpha-fetoprotein (AFP), carcinoembryonic antigen, carbohydrate antigen (CA) 19-9, CA242, and CA50 were analyzed to evaluate their diagnostic values in single and combined tests for distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). Preoperative serum levels of AFP, carcinoembryonic antigen, CA19-9, CA242, and CA50 were measured in 45 ICC and 76 HCC patients. The serum levels and the positive rate of AFP, CA19-9, and CA242 were significantly different between the ICC patients and HCC patients. Although AFP (—) was the most sensitive assay for distinguishing ICC from HCC (91.1%), its specificity was significantly lower than that of CA242 (+) and CA19-9 (+). The combination of AFP (-) and CA242 (+) afforded a high specificity of 94.3 per cent and showed highest accuracy (78.5%). Evaluation of patients without liver cirrhosis also showed similar results. The diagnostic value of CA242 (+) is better than that of CA19-9 (+) and AFP (-) in distinguishing ICC from HCC. Combined detection of AFP (—) and CA242 (+) can improve the specificity and accuracy of diagnosing ICC.

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Tumor Markers Reflect Tumor Burden of Pseudomyxoma Peritonei

10.21203/rs.3.rs-691313/v1 ◽

2021 ◽

Author(s):

Mingjian Bai ◽

Shaojun Pang ◽

Yiyan Lu ◽

Hongjiang Wei ◽

Jing Feng ◽

...

Keyword(s):

Tumor Markers ◽

Pseudomyxoma Peritonei ◽

Peritoneal Cancer Index ◽

Tumor Burden ◽

Ca 125 ◽

P Value ◽

Peritoneal Cancer ◽

Serum Tumor Markers ◽

Ca 242 ◽

Preoperative Serum

Abstract Background: Accurate assessment of preoperative tumor burden contribute to formulate a scientific surgical plan and improve the prognosis of patients with pseudomyxoma peritonei (PMP). Present study aimed to assess whether preoperative serum tumor markers could reflect tumor burden. Methods: A total of 198 PMP patients were included, the peritoneal cancer index (PCI) was employed to reflect tumor burden for PMP patients. All participants were divided into low (PCI ≤ 19) and high (PCI ≥ 20) tumor burden subgroups according to PCI. All serum tumor markers (carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), CA 19-9, CA 724, and CA 242) were compared between the two subgroups. The correlation between tumor markers and PCI will be calculated and compared with each other. Two-sided P value less than 0.05 is considered statistically significant.Results: The level of CEA (ng/ml), CA125 (U/ml), CA 19-9 (U/ml), CA 724 (U/ml), and CA 242 (kU/L) between low and high tumor burden subgroup were [3.35 (1.64, 16.31) vs. 23.12 (8.80, 67.62), Z = -5.381, p<0.001], [19.10 (7.61, 56.95) vs. 72.75 (40.41, 130.55), Z = -5.978, p < 0.001], [6.17 (3.26, 16.22) vs. 45.50 (13.95, 123.61), Z = -5.413, p < 0.001], [7.89 (1.57, 45.10) vs. 84.61 (33.87, 236.93), Z = -5.898, p < 0.001], and [13.32 (3.39, 96.50) vs. 150.00 (102.13, 308.88), Z = -5.166, p < 0.001], respectively. The Spearman correlation between tumor markers and PCI were 0.415 for CEA (p < 0.001), 0.372 for CA 125 (p < 0.001), 0.466 for CA 19-9 (p < 0.001), 0.379 for CA 724 (p < 0.001), and 0.317 for CA 242 (p < 0.001), respectively. Conclusions: Preoperative serum tumor markers could moderately reflect tumor burden for PMP, which may contribute to develop a better surgical plan before operation.

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