Preoperative Serum Carcinoembryonic Antigen, Carbohydrate Antigen19-9 and Carbohydrate Antigen 125 as Prognostic Factors for Recurrence-free Survival in Colorectal Cancer

Objective: Colorectal cancer (CRC) is among the most common malignancies worldwide. Understanding CRCprognosis at the initial diagnosis is very important for therapeutic strategy selection. This study was conductedto evaluate the prognostic value of preoperative serum carbohydrate antigen 19-9 (CA19-9), carcinoembryonicantigen (CEA) and carbohydrate antigen 125 (CA125) for predicting 5-year recurrence-free survival (RFS) inCRC patients.
Methods: Preoperative serum CA19-9, CEA and CA125 levels were detected by C12 proteinchip diagnostic system in 103 patients with CRC, and their correlations with the 5-year RFS were analyzed.
Results: Patients with positive preoperative serum CA19-9, CEA and CA125 had higher 5-year recurrent rates(75.0% vs 41.0%, 65.6% vs 39.4%, and 87.5% vs 44.2% respectively, all p<0.05), and reduced median RFS (14vs 35 months, 20 vs 36 months, and 4 vs 35 months respectively, all p<0.05) compared with patients negative forcorresponding tumor marker (TM). The median RFS was 59 months (95% CI 28.9-89.1 months) with negativeTMs, 14 months (95% CI 4.5-23.5) for 1~2 positive TMs, and 4 months (95% CI 2.4-5.6) for all 3 positive TMs.Patients with simultaneously positive serum CA19-9, CEA and CA125 had the highest recurrence rate (100%)and the shortest RFS (median 4 months). Univariate analysis showed that stage and the preoperative singleTM or combined TMs correlated with RFS, whereas multivariate Cox regression model analysis revealed onlystage and preoperative serum status of CEA+CA19-9+CA125 to be independent prognostic factors.
Conclusion:Preoperative serum CA19-9+CEA+CA125 can be used an independent prognostic factor for CRC 5-year RFS.