title: CEACAM-7: a predictive marker for rectal cancer recurrence.
abstract: BACKGROUND
  The identification of rectal cancer patients predisposed to developing recurrent disease could allow directed adjuvant therapy to improve outcomes while decreasing unnecessary morbidity. This study evaluates carcinoembryonic antigen cellular adhesion molecule-7 (CEACAM-7) expression in rectal cancer as a predictive recurrence factor.
  
  
  METHODS
  A single-institution colorectal cancer database and a frozen tissue biobank were queried for rectal cancer patients. CEACAM-7 messenger RNA (mRNA) expression from normal rectal mucosa and rectal cancers was analyzed using quantitative real-time polymerase chain reaction (PCR). Expression-level differences among normal tissue, disease-free survivors, and those that developed recurrence were analyzed.
  
  
  RESULTS
  Eighty-four patients were included in the study, which consisted of 37 patients with nonrecurrent disease (median follow-up, 170 months), 29 patients with recurrent disease, and 18 patients with stage IV disease. CEACAM-7 expression was decreased 21-fold in rectal cancers compared with normal mucosa (P = .002). The expression levels of CEACAM-7 were relatively decreased in tumors that developed recurrence compared with nonrecurrence, significantly for stage II patients (14-fold relative decrease, P = .002). For stages I-III, disease-free survival segregates were based on relative CEACAM-7 expression values (P = .036), specifically for stage II (P = .018).
  
  
  CONCLUSIONS
  CEACAM-7 expression is significantly decreased in rectal cancer. Expression differences between long-term survivors and those with recurrent disease introduce a potential tumor marker to define a subset of patients who benefit most from adjuvant therapy.
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue, A30, Cleveland, OH 44106, USA. craigatcase@yahoo.com
authors.forename: Craig A
authors.initials: CA
authors.lastname: Messick
authors.forename: Julian
authors.initials: J
authors.lastname: Sanchez
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Dejulius
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hammel
authors.forename: Hemant
authors.initials: H
authors.lastname: Ishwaran
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Kalady
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics*; D002272:Carcinoembryonic Antigen; D015815:Cell Adhesion Molecules / Q000235:genetics*; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D058851:GPI-Linked Proteins; D006801:Humans; D007413:Intestinal Mucosa / Q000502:physiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000235:genetics / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012333:RNA, Messenger / Q000378:metabolism; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000401:mortality; D014015:Tissue Banks
chemical_list: D014408:Biomarkers, Tumor; C091223:CEACAM7 protein, human; D002272:Carcinoembryonic Antigen; D015815:Cell Adhesion Molecules; D058851:GPI-Linked Proteins; D012333:RNA, Messenger