Preoperative serum markers in carcinoma of the rectum and rectosigmoid. II. Prediction of prognosis.
The prognostic value of a single preoperative determination of the serum (S) concentration of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and the carcinoma-associated carbohydrate antigen CA-50, either alone or in combination was evaluated in 327 consecutive patients with carcinoma of the rectum. A strong correlation was found between the serum level of each of these tumour markers separately, and prognosis, both in terms of crude survival in all patients and in disease-free survival in 'potentially cured' patients. The prognostic information provided by S-TPA and S-CA-50 was stronger, however, than that given by S-CEA. In a multivariate approach, S-TPA was found to be most informative. With use of the Cox regression model, the critical serum values that best separated patients in regard to mortality were CEA 18 micrograms/l, TPA 120 U/l and S-CA-50 40 U/ml. The critical values that best discriminated disease-free survival in 'potentially cured' patients were CEA 12 micrograms/l, TPA 110 U/l and S-CA-50 28 U/ml. The clinical usefulness of these and other cut-off levels is discussed.
Ståhle
E
E
Department of Surgery, University of Uppsala, Akademiska sjukhuset, Sweden.
Glimelius
B
B
Bergström
R
R
Påhlman
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000032:analysis; D000951:Antigens, Neoplasm / Q000032:analysis; D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002277:Carcinoma / Q000097:blood* / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010455:Peptides / Q000032:analysis; D011379:Prognosis; D012004:Rectal Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D012811:Sigmoid Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D019396:Tissue Polypeptide Antigen
D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm; D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D010455:Peptides; D019396:Tissue Polypeptide Antigen