Elevated Preoperative Serum CEA Level Is Associated with Poor Prognosis in Patients with Hepatocellular Carcinoma Through the Epithelial-Mesenchymal Transition.
Serum carcinoembryonic antigen (CEA) is used as an indicator of tumor progression in a variety of carcinomas. A subset of patients with hepatocellular carcinoma (HCC) exhibit increased serum CEA level, but the significance of this is unclear. In this study, we investigated the prognosis of patients with HCC with increased serum CEA, and explored the correlations with expression of carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) and epithelial-mesenchymal transition (EMT) and tumor angiogenesis.



One hundred and twenty-three patients with HCC who underwent radical resection were divided into two groups according to a cut-off value of 5.0 ng/ml for serum CEA: high (n=24) and normal (n=99) groups. We compared the clinicopathological factors with serum CEA levels and its correlations with CEACAM1 expression, EMT-related factors and microvessel density (MVD) of tumor tissues by immunohistochemistry.



In the high CEA group, the disease-free survival (DFS) rate was significantly worse than in the normal CEA group. Multivariate analysis revealed that a high CEA level was an independent factor predictive of recurrence. Furthermore, increased serum CEA levels were positively correlated with CEACAM1 expression. Moreover, CEACAM1 expression was positively correlated with expression of EMT-related factors and MVD of tumor tissues.



Increased serum CEA level reflected CEACAM1 expression and was an independent factor predictive of recurrence in HCC through EMT and tumor angiogenesis.
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Masato
M
Yoshikawa
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Yuji
Y
Morine
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Tetsuya
T
Ikemoto
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Satoru
S
Imura
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Jun
J
Higashijima
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Shuichi
S
Iwahashi
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Y U
YU
Saito
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Chie
C
Takasu
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Shinichiro
S
Yamada
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Daichi
D
Ishikawa
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Hiroki
H
Teraoku
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Atsushi
A
Takata
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan.
Toshiaki
T
Yoshimoto
Department of DigestiveSurgery, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Japan mitsuo.shimada@tokushima-u.ac.jp.
Mitsuo
M
Shimada
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D015820:Cadherins / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000601:surgery; D015815:Cell Adhesion Molecules / Q000378:metabolism; D018572:Disease-Free Survival; D058750:Epithelial-Mesenchymal Transition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000097:blood* / Q000601:surgery; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D012008:Recurrence; D014746:Vimentin / Q000378:metabolism
D015703:Antigens, CD; D018952:Antigens, CD34; C069847:CD66 antigens; C513384:CDH1 protein, human; D015820:Cadherins; D002272:Carcinoembryonic Antigen; D015815:Cell Adhesion Molecules; D014746:Vimentin
CEA; CEACAM; epithelial mesenchymal transition; hepatocellular carcinoma