Correlation Between Serum Levels Of CEA, CA19-9, CA72-4 And The Efficacy Of Chemotherapy In Patients With Metastatic Colorectal Cancer

AIM:To investigate the relationship between the baseline and the dynamic change of serum levels of CEA, CA19-9, CA72-4 and the efficacy of chemotherapy in patients with metastatic colorectal cancer.METHODS:We retrospectively collected the demographic, histopathological, clinical, laboratory and radiological data, ORR, PFS and OS after first-line chemotherapy for metastatic colorectal patients from May 2009 to March 2016 in the Affiliated Tumor Hospital of Guangxi Medical University. According to the baseline serum levels of CEA, CA19-9, CA72-4, patients were divided into four group:all markers were negative (Negative group), one marker was positive (one-positive group), two markers were positive (two-positive group) and three markers were positive (three-positive group).We compare the differences of four groups in clinical and pathological features, objective efficacy and long-term survival. In addition, we compare the objective remission and long-term survival of Negative group patients whose markers did or didn’t turn to positive.RESULTS:One hundred and fifty-two metastatic colorectal cancer patients fulfilled the inclusion criteria were selected into the study:69 cases in the negative group,37 in one-positive group,28 in two-positive group,18 in three-positive group. There were no significant difference among four groups in gender, age, gross pathological type, histological type, degree of differentiation (P>0.05). All patients received first-line chemotherapy with FOLFOX4 or mFOLFOX6 or XELOX or FOLFIRI. The objective re-sponse rate was similar(P>0.05) in four group, which was 19.7%,12.5%,25.9% and 12.5%, respect-ively. The median progression-free survival was 5.0 months in three-positive group, which was significantly shorter (P<0.05) than that of negative group(16.4 months), one-positive group(12.0months) and two-positive group(9.4moths). No significant difference was observed among Negative group, one-positive group and two-positive group (P>0.05). The median overall survival of 39.1 months in negative group was significantly longer than that of three-positive group(12.7 months) (P<0.05).There were no significant difference between negative group and one-positive group, and also between two-positive group and three-positive group (P>0.05).In negative group, the CEA levels maintain negative in 39 patients with a median PFS(26 months) and median OS(43.5months) was significantly longer than those 30 patients whose CEA levels converted to positive(10.4 months and 33.0 months, respectively). There are no significant different PFS or OS in patients with CA19-9 or CA72-4 did or did not turn to positive.CONCLUSION:1. In mCRC patients, the baseline levels of serum CEA, CA19-9, CA72-4 correlated to the outcomes of chemotherapy. Patients with all markers negative have the longest PFS and OS.2. The change of serum CEA levels from negative to positive correlated to worse PFS and OS in mCRC patients.