Prognostic value of normal levels of preoperative tumor markers in colorectal cancer
Abstract Carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), and alpha-fetoprotein (AFP) are widely used tumor markers for colorectal cancer (CRC), but their clinical significance is unknown when the levels of these tumor markers were within the norm...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-12-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-49832-5 |
| _version_ | 1827399483189624832 |
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| author | Guangming Ren Ruikai Li Gaozan Zheng Kunli Du Hanjun Dan Hongze Wu Xinyu Dou Lili Duan Zhenyu Xie Liaoran Niu Ye Tian Jianyong Zheng Fan Feng |
| author_facet | Guangming Ren Ruikai Li Gaozan Zheng Kunli Du Hanjun Dan Hongze Wu Xinyu Dou Lili Duan Zhenyu Xie Liaoran Niu Ye Tian Jianyong Zheng Fan Feng |
| author_sort | Guangming Ren |
| collection | DOAJ |
| description | Abstract Carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), and alpha-fetoprotein (AFP) are widely used tumor markers for colorectal cancer (CRC), but their clinical significance is unknown when the levels of these tumor markers were within the normal range. This retrospective study included 2145 CRC patients. The entire cohort was randomly divided into training and validation datasets. The optimal cut-off values of tumor markers were calculated using X-tile software, and univariate and multivariate analyses were performed to assess its association with overall survival (OS). The nomogram model was constructed and validated. The entire cohort was randomly divided into a training dataset (1502 cases, 70%) and a validation dataset (643 cases,30%). Calculated from the training dataset, the optimal cut-off value was 2.9 ng/mL for CEA, 10.1 ng/mL for CA19-9, 13.4 U/mL for CA125, and 1.8 ng/mL for AFP, respectively. Multivariate analysis revealed that age, tumor location, T stage, N stage, preoperative CA19-9, and CA125 levels were independent prognostic predictors. Even within the normal range, CRC patients with relatively high levels of CA19-9 or CA125 worse OS compared to those with relatively low levels. Then, based on the independent prognostic predictors from multivariate analysis, two models with/without (model I/II) CA19-9 and CA125 were built, model I showed better prediction and reliability than model II. Within the normal range, relatively high levels of preoperative CA19-9 and CA125 were significantly associated with poor OS in CRC patients. The nomogram based on CA19-9 and CA125 levels showed improved predictive accuracy ability for CRC. |
| first_indexed | 2024-03-08T19:46:37Z |
| format | Article |
| id | doaj.art-b54de08e59d34e918477f676145cb141 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-08T19:46:37Z |
| publishDate | 2023-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-b54de08e59d34e918477f676145cb1412023-12-24T12:18:59ZengNature PortfolioScientific Reports2045-23222023-12-0113111210.1038/s41598-023-49832-5Prognostic value of normal levels of preoperative tumor markers in colorectal cancerGuangming Ren0Ruikai Li1Gaozan Zheng2Kunli Du3Hanjun Dan4Hongze Wu5Xinyu Dou6Lili Duan7Zhenyu Xie8Liaoran Niu9Ye Tian10Jianyong Zheng11Fan Feng12Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityDepartment of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical UniversityAbstract Carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), and alpha-fetoprotein (AFP) are widely used tumor markers for colorectal cancer (CRC), but their clinical significance is unknown when the levels of these tumor markers were within the normal range. This retrospective study included 2145 CRC patients. The entire cohort was randomly divided into training and validation datasets. The optimal cut-off values of tumor markers were calculated using X-tile software, and univariate and multivariate analyses were performed to assess its association with overall survival (OS). The nomogram model was constructed and validated. The entire cohort was randomly divided into a training dataset (1502 cases, 70%) and a validation dataset (643 cases,30%). Calculated from the training dataset, the optimal cut-off value was 2.9 ng/mL for CEA, 10.1 ng/mL for CA19-9, 13.4 U/mL for CA125, and 1.8 ng/mL for AFP, respectively. Multivariate analysis revealed that age, tumor location, T stage, N stage, preoperative CA19-9, and CA125 levels were independent prognostic predictors. Even within the normal range, CRC patients with relatively high levels of CA19-9 or CA125 worse OS compared to those with relatively low levels. Then, based on the independent prognostic predictors from multivariate analysis, two models with/without (model I/II) CA19-9 and CA125 were built, model I showed better prediction and reliability than model II. Within the normal range, relatively high levels of preoperative CA19-9 and CA125 were significantly associated with poor OS in CRC patients. The nomogram based on CA19-9 and CA125 levels showed improved predictive accuracy ability for CRC.https://doi.org/10.1038/s41598-023-49832-5 |
| spellingShingle | Guangming Ren Ruikai Li Gaozan Zheng Kunli Du Hanjun Dan Hongze Wu Xinyu Dou Lili Duan Zhenyu Xie Liaoran Niu Ye Tian Jianyong Zheng Fan Feng Prognostic value of normal levels of preoperative tumor markers in colorectal cancer Scientific Reports |
| title | Prognostic value of normal levels of preoperative tumor markers in colorectal cancer |
| title_full | Prognostic value of normal levels of preoperative tumor markers in colorectal cancer |
| title_fullStr | Prognostic value of normal levels of preoperative tumor markers in colorectal cancer |
| title_full_unstemmed | Prognostic value of normal levels of preoperative tumor markers in colorectal cancer |
| title_short | Prognostic value of normal levels of preoperative tumor markers in colorectal cancer |
| title_sort | prognostic value of normal levels of preoperative tumor markers in colorectal cancer |
| url | https://doi.org/10.1038/s41598-023-49832-5 |
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