title: [Correlation of carcinoembryonic antigen with prognosis of hepatocellular carcinoma after hepatectomy].
abstract: OBJECTIVE
  To investigate the correlation between carcinoembryonic antigen (CEA) and prognosis of hepatocellular carcinoma after hepatectomy.
  
  
  METHODS
  This study retrospectively analyzed the surgical outcomes of hepatocellular carcinoma (HCC) in 562 patients who underwent hepatectomy between January 2002 and December 2009 in the Cancer Hospital, Chinese Academy of Medical Sciences. Postoperative prognostic factors were analyzed using univariate Kaplan-Meier analysis and multivariate Cox proportional hazards model.
  
  
  RESULTS
  The sensibility of serum CEA and CEA-AFP combined in the detection of HCC was 7.1% (40/562) and 55.3% (311/562), respectively. The 1-, 3- and 5-year overall survival rates and disease free survival rates of CEA-negative group (CEA<5 ng/ml) were 93.8%, 75.6%, 59.4%, and 75.0%, 55.9%, 44.5%, respectively (P = 0.003); and the 1-, 3- and 5-year overall survival rates and disease free survival rates of CEA-positive group (CEA ≥ 5 ng/ml) were 87.5%, 60.5%, 46.6% and 52.6%, 36.2%, and 25.4%, respectively (P = 0.045). In the univariate analysis, better prognosis for overall survival (OS) was associated with small tumor ( ≤ 5 cm), single lesion, high-grade histological differentiation, no vascular tumor embolus, negative serum AFP expression, negative serum CEA expression, no/mild cirrhosis, no regional lymph node metastasis, no major vascular invasion, no direct invasion of adjacent organs or with perforation of visceral peritoneum, no transfusion as well as earlier BCLC staging (P < 0.05 for all). In the Cox multivariate analysis, serum AFP-negative expression, serum CEA-negative expression, no/mild cirrhosis, no direct invasion of adjacent organs or with perforation of visceral peritoneum, no transfusion and earlier BCLC staging were independent factors for longer disease free survival (P < 0.05 for all).
  
  
  CONCLUSIONS
  Serum CEA-positive expression is correlated to alcoholism and HCC multiple occurrences. Although serum CEA detection has limited value for HCC diagnosis, its positive expression does affect poor prognosis. Higher serum CEA level is an independent prognostic factor for poorer disease free survival.
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Yan
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Bi
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China. Email: blizzardyt@163.com.
authors.forename: Jianqiang
authors.initials: J
authors.lastname: Cai
mesh_terms: D002272:Carcinoembryonic Antigen / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000378:metabolism; D018572:Disease-Free Survival; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D002272:Carcinoembryonic Antigen