Prognostic value of dynamic changes of pre‑ and post‑operative tumor markers in colorectal cancer

• Guangming Ren ^[1] ; Gaozan Zheng ^[1] ; Kunli Du ^[1] ; Hanjun Dan ^[1] ; Xinyu Dou ^[1] ; Lili Duan ^[1] ; Zhenyu Xie ^[1] ; Liaoran Niu ^[1] ; Ye Tian ^[1] ; Jianyong Zheng ^[1] ; Fan Feng ^[1] ; Zhangfeng Dang ^[2]
  1. [1] Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  2. [2] Department of General Surgery, Air Force 986(Th) Hospital, Fourth Military Medical University, Xi’an, China
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 8, 2024, págs. 2047-2059
• Idioma: inglés
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• Resumen

  • Background Colorectal cancer (CRC) prognosis assessment is vital for personalized treatment plans. This study investigates the prognostic value of dynamic changes of tumor markers CEA, CA19-9, CA125, and AFP before and after surgery and constructs prediction models based on these indicators.

    Methods A retrospective clinical study of 2599 CRC patients who underwent radical surgery was conducted. Patients were randomly divided into training (70%) and validation (30%) datasets. Univariate and multivariate Cox regression analyses identified independent prognostic factors, and nomograms were constructed.

    Results A total of 2599 CRC patients were included in the study. Patients were divided into training (70%, n = 1819) and validation (30%, n = 780) sets. Univariate and multivariate Cox regression analyses identified age, total number of resected lymph nodes, T stage, N stage, the preoperative and postoperative changes in the levels of CEA, CA19-9, and CA125 as independent prognostic factors. When their postoperative levels are normal, patients with elevated preoperative levels have significantly worse overall survival. However, when the postoperative levels of CEA/CA19-9/CA125 are elevated, whether their preoperative levels are elevated or not has no significance for prognosis. Two nomogram models were developed, and Model I, which included CEA, CA19-9, and CA125 groups, demonstrated the best performance in both training and valida- tion sets.

    Conclusion This study highlights the significant predictive value of dynamic changes in tumor markers CEA, CA19-9, and CA125 before and after CRC surgery. Incorporating these markers into a nomogram prediction model improves prognostic accuracy, enabling clinicians to better assess patients’ conditions and develop personalized treatment plans.