학술논문
Transient Changes in Serum CEA, CA19-9, CRP, YKL-40, and IL-6 during Adjuvant Chemotherapy and Survival of Patients with Colorectal Cancer.
Document Type
Academic Journal
Author
Lehtomäki K; Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland.; Department of Oncology: Tays Cancer Center, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland.; Heervä E; Department of Oncology, Turku University Hospital, Hämeentie 11, 20520 Turku, Finland.; Department of Oncology, University of Turku, Kiinanmyllynkatu 10, 20520 Turku, Finland.; Kellokumpu-Lehtinen PL; Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland.; Research, Development and Innovation Center, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland.; Mustonen H; Department of Surgery, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland.; Research Programs Unit, Translational Cancer Medicine Program, University of Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland.; Salminen T; Department of Oncology: Tays Cancer Center, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland.; Joensuu H; Department of Oncology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland.; Hermunen K; Department of Surgery, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland.; Boisen MK; Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls vej 1, DK-2730 Herlev, Denmark.; Johansen JS; Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls vej 1, DK-2730 Herlev, Denmark.; Department of Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital and University of Copenhagen, Borgmester Ib Juuls vej 1, DK-2730 Herlev, Denmark.; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark.; Haglund C; Department of Surgery, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland.; Research Programs Unit, Translational Cancer Medicine Program, University of Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland.; Osterlund P; Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland.; Department of Oncology: Tays Cancer Center, Tampere University Hospital, Teiskontie 35, 33520 Tampere, Finland.; Department of Oncology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland.; Department of Gastrointestinal Oncology, Tema Cancer, Karolinska Universitetssjukhuset, Eugeniavägen 3, 17176 Solna, Sweden.; Department of Oncology-Pathology, Karolinska Institutet, Solnavägen 1, 17177 Solna, Sweden.
Source
Publisher: MDPI Country of Publication: Switzerland NLM ID: 101092791 Publication Model: Electronic Cited Medium: Internet ISSN: 1422-0067 (Electronic) Linking ISSN: 14220067 NLM ISO Abbreviation: Int J Mol Sci Subsets: MEDLINE
Subject
Language
English
Abstract
Serum carcinoembryonic antigen (CEA) is frequently monitored to detect colorectal cancer (CRC) recurrence after surgery. The clinical significance of transiently increased CEA during adjuvant chemotherapy is poorly understood. Serum CEA, CA19-9, CRP, YKL-40, and IL-6 were measured before, during, and after adjuvant 5-fluorouracil-based chemotherapy in the randomised LIPSYT study population. The biomarker kinetic patterns were classified into three groups: no increase, a transient increase (≥10% increase followed by a decrease), and a persistent increase during the adjuvant treatment, and the associations of these patterns with disease free-survival (DFS) and overall survival (OS) were investigated by using Cox regression analyses. The findings were validated in two single-centre cohorts that received modern adjuvant chemotherapy. A transient increase in CEA occurred in about a half of the patients during chemotherapy, in all the cohorts. The patients with a transient increase had a roughly similar DFS and OS to the patients with no increase, and a more favourable survival compared to the patients with a persistent increase. In the LIPSYT cohort, the hazard ratio was 0.21 for DFS (CI 95% 0.07-0.66) and 0.24 for OS (CI 95% 0.08-0.76). Transient increases in CA19-9 and YKL-40 tended to be associated with a favourable survival. A transient increase in CEA during adjuvant chemotherapy is associated with a favourable survival when compared with a persistent increase.