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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2016

01-04-2016 | Gastrointestinal Oncology

Prognostic Significance of Carcinoembryonic Antigen Staining in Cancer Tissues of Gastric Cancer Patients

Authors: Wei Wang, MD, PhD, Sharvesh Raj Seeruttun, MD, Cheng Fang, MD, Jiewei Chen, MD, Yong Li, MD, Zhimin Liu, MD, PhD, Youqing Zhan, MD, Wei Li, MD, Yingbo Chen, MD, Xiaowei Sun, MD, Yuanfang Li, MD, PhD, Dazhi Xu, MD, PhD, Yuanxiang Guan, MD, Zhiwei Zhou, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2016

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Abstract

Purpose

The aim of this study was to assess the significance of the correlation among tissue carcinoembryonic antigen (CEA) expression with serum CEA (sCEA) levels and long-term survival to highlight the clinical prognostic significance of tissue CEA expression in gastric cancer patients.

Methods

Immunohistological method and radioimmunoassay were used to assess tissue and sCEA expression, respectively. Univariate and multivariate analyses were performed to determine correlations, and the Kaplan–Meier method was used to investigate the prognostic significance.

Results

Our results demonstrate that tissue CEA in gastric cancer is significantly correlated with preoperative sCEA levels (p = 0.031), depth of invasion (p = 0.001), lymph node metastasis (p < 0.001), distant metastasis (p = 0.001), and TNM staging (p < 0.001). The 5-year survival rates were 67.6, 53.9, and 40.1 % for negatively, moderately, and intensely positively stained tissues (p < 0.001), and 57.0 and 37.9 % for serum with normal and elevated CEA expression (p = 0.031). Multivariate analysis revealed that tissue CEA can be considered an independent prognostic factor. Further analysis illustrated that patients with negative expression in both tissue and serum had better prognosis compared with those positively expressing CEA in both tissue and serum and/or those positively expressing CEA in either tissue or serum (p < 0.001). Our results also demonstrated that patients with negative tissue CEA staining and elevated sCEA expression had a better 5-year survival.

Conclusion

Tissue CEA expression in gastric cancer is directly correlated with sCEA levels and long-term prognosis. Thus, tissue CEA expression can be considered as a useful biomarker to improve the interpretation of sCEA levels in predicting long-term survival.
Literature
1.
Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24(14):2137–50.CrossRefPubMed
2.
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108.CrossRefPubMed
3.
Lim JS, Yun MJ, Kim MJ, et al. CT and PET in stomach cancer: preoperative staging and monitoring of response to therapy. Radiographics. 2006;26(1):143–56.CrossRefPubMed
4.
Posner MR, Mayer RJ. The use of serologic tumor markers in gastrointestinal malignancies. Hematol Oncol Clin N Am. 1994;8(3):533–53.
5.
Takahashi Y, Takeuchi T, Sakamoto J, et al. The usefulness of CEA and/or CA19-9 in monitoring for recurrence in gastric cancer patients: a prospective clinical study. Gastric Cancer. 2003;6(3):142–5.CrossRefPubMed
6.
Thompson J, Zimmermann W, Osthus-Bugat P, et al. Long-range chromosomal mapping of the carcinoembryonic antigen (CEA) gene family cluster. Genomics. 1992;12(4):761–72.CrossRefPubMed
7.
Tamada R, Hiramoto Y, Tsujitani S, et al. Serum CEA levels facilitate detection of recurrences of cancer in patients after gastrectomy. Jpn J Surg. 1985;15(1):23–9.CrossRefPubMed
8.
Park SH, Ku KB, Chung HY, Yu W. Prognostic significance of serum and tissue carcinoembryonic antigen in patients with gastric adenocarcinomas. Cancer Res Treat. 2008;40(1):16–21.CrossRefPubMedPubMedCentral
9.
Bhatnagar J, Heroman W, Murphy M, Austin GE. Immunohistochemical detection of carcinoembryonic antigen in esophageal carcinomas: a comparison with other gastrointestinal neoplasms. Anticancer Res. 2002;22(3):1849–57.PubMed
10.
Nazato DM, Matos LL, Waisberg DR, Souza JR, Martins LC, Waisberg J. Prognostic value of carcinoembryonic antigen distribution in tumor tissue of colorectal carcinoma. Arq Gastroenterol. 2009;46(1):26–31.CrossRefPubMed
11.
Okamura A, Ohkawa J, Fujisawa H, Sashikata T. Clinicopathological study on the relationship between serum-CEA and tissue-CEA of resected lung cancer cases. Acta Pathol Jpn. 1984;34(6):1209–19.PubMed
12.
Michaelidou K, Tzovaras A, Missitzis I, Ardavanis A, Scorilas A. The expression of the CEACAM19 gene, a novel member of the CEA family, is associated with breast cancer progression. Int J Oncol. 2013;42(5):1770–77.PubMed
13.
Han CP, Lee MY, Kok LF, et al. A reappraisal of three-marker (ER/Vim/CEA), four-marker (ER/Vim/CEA/PR), and five-marker (ER/Vim/CEA/PR/p16INK4a) panels in the diagnostic distinction between primary endocervical and endometrial adenocarcinomas in a tissue microarray study. Arch Gynecol Obstet. 2010;281(5):845–50.CrossRefPubMed
14.
Smithson JE, Warren BF, Young S, Pigott R, Jewell DP. Heterogeneous expression of carcinoembryonic antigen in the normal colon and upregulation in active ulcerative colitis. J Pathol. 1996;180(2):146–51.CrossRefPubMed
15.
Isaacson P, Judd MA. Carcinoembryonic antigen (CEA) in the normal human small intestine: a light and electron microscopic study. Gut. 1977;18(10):786–91.CrossRefPubMedPubMedCentral
16.
Bunn PA Jr, Cohen MI, Widerlite L, Nugent JL, Matthews MJ, Minna JD. Simultaneous gastric and plasma immunoreactive plasma carcinoembryonic antigen in 108 patients undergoing gastroscopy. Gastroenterology. 1979;76(4):734–41.PubMed
17.
Charalabopoulos K, Kotsalos A, Batistatou A, et al. Serum and tissue selenium levels in gastric cancer patients and correlation with CEA. Anticancer Res. 2009;29(8):3465–67.PubMed
18.
Kojima O, Ikeda E, Uehara Y, Majima T, Fujita Y, Majima S. Correlation between carcinoembryonic antigen in gastric cancer tissue and survival of patients with gastric cancer. Gan. 1984;75(3):230–36.PubMed
19.
Nishida H. Immunohistochemical localization of carcinoembryonic antigen (CEA) in gastric cancer–a comparative study between tissue CEA and plasma CEA [in Japanese]. Nihon Geka Gakkai Zasshi. 1983;84(4):328–35.PubMed
20.
Rosandić-Pilas M, Hadzic N, Stavljenic A, Juricic M, Scukanec-Spoljar M. Relationship between tissue and serum concentrations of carcinoembryonic antigen (CEA) in gastric and colonic carcinomas. Acta Med Austriaca. 1990;17(5):89–93.PubMed
21.
Lee JC, Lee SY, Kim CY, Yang DH. Clinical utility of tumor marker cutoff ratio and a combination scoring system of preoperative carcinoembryonic antigen, carbohydrate antigen 19-9, carbohydrate antigen 72-4 levels in gastric cancer. J Korean Surg Soc. 2013;85(6):283–89.CrossRefPubMedPubMedCentral
22.
Zhou H, Stanners CP, Fuks A. Specificity of anti-carcinoembryonic antigen monoclonal antibodies and their effects on CEA-mediated adhesion. Cancer Res. 1993;53(16):3817–22.PubMed
23.
Beauchemin N, Draber P, Dveksler G, et al. Redefined nomenclature for members of the carcinoembryonic antigen family. Exp Cell Res. 1999;252(2):243–49.CrossRefPubMed
24.
Bjerner J, Lebedin Y, Bellanger L, et al. Protein epitopes in carcinoembryonic antigen. Report of the ISOBM TD8 workshop. Tumour Biol. 2002;23(4):249–62.CrossRefPubMed
25.
Chiquillo Barber MT, Bort Marti I, Navarro Fos S, Perez Bacete M, Esclapez Valero J, Gomez-Ferrer Bayo F. A correlation between serum levels of preoperative CEA and CEA immunohistochemical staining in colorectal carcinoma [in Spanish]. Rev Esp Enferm Dig. 1993;83(4):249–54.PubMed
26.
Hammarstrom S. The carcinoembryonic antigen (CEA) family: structures, suggested functions and expression in normal and malignant tissues. Semin Cancer Biol. 1999;9(2):67–81.CrossRefPubMed
27.
Burtin P, von Kleist S, Sabine MC, King M. Immunohistological localization of carcinoembryonic antigen and nonspecific cross-reacting antigen in gastrointestinal normal and tumoral tissues. Cancer Res. 1973;33(12):3299–305.PubMed
28.
Ikeda Y, Mori M, Kamakura T, Haraguchi Y, Saku M, Sugimachi K. Increased incidence of undifferentiated type of gastric cancer with tumor progression in 912 patients with early gastric cancer and 1245 with advanced gastric cancer. Cancer. 1994;73(10):2459–63.CrossRefPubMed
29.
Kodera Y, Isobe K, Yamauchi M, et al. Expression of carcinoembryonic antigen (CEA) and nonspecific crossreacting antigen (NCA) in gastrointestinal cancer; the correlation with degree of differentiation. Br J Cancer. 1993;68(1):130–36.CrossRefPubMedPubMedCentral
30.
Imamura T, Komatsu S, Ichikawa D, et al. Poor prognostic subgroup in T3N0 stage IIA gastric cancer, suggesting an indication for adjuvant chemotherapy. J Surg Oncol. 2015;111(2):221–25.CrossRefPubMed
31.
Takahari D, Hamaguchi T, Yoshimura K, et al. Survival analysis of adjuvant chemotherapy with S-1 plus cisplatin for stage III gastric cancer. Gastric Cancer. 2014;17(2):383–386.CrossRefPubMed
32.
Min C, Bangalore S, Jhawar S, et al. Chemoradiation therapy versus chemotherapy alone for gastric cancer after R0 surgical resection: a meta-analysis of randomized trials. Oncology. 2014;86(2):79–85.CrossRefPubMed
33.
Stessin AM, Sison C, Schwartz A, Ng J, Chao CK, Li B. Does adjuvant radiotherapy benefit patients with diffuse-type gastric cancer? Results from the surveillance, epidemiology, and end results database. Cancer. 2014;120(22):3562–68.CrossRefPubMed
34.
Foo M, Crosby T, Rackley T, Leong T. Role of (chemo)-radiotherapy in resectable gastric cancer. Clin Oncol (R Coll Radiol). 2014;26(9):541–50.CrossRefPubMed
35.
Lordick F, Lorenzen S, Yamada Y, Ilson D. Optimal chemotherapy for advanced gastric cancer: is there a global consensus? Gastric Cancer. 2014;17(2):213–25.CrossRefPubMed
36.
Oh DY, Bang YJ. Adjuvant and neoadjuvant therapy for gastric cancer. Curr Treat Options Oncol. 2013;14(3):311–20.CrossRefPubMed
Metadata
Title
Prognostic Significance of Carcinoembryonic Antigen Staining in Cancer Tissues of Gastric Cancer Patients
Authors
Wei Wang, MD, PhD
Sharvesh Raj Seeruttun, MD
Cheng Fang, MD
Jiewei Chen, MD
Yong Li, MD
Zhimin Liu, MD, PhD
Youqing Zhan, MD
Wei Li, MD
Yingbo Chen, MD
Xiaowei Sun, MD
Yuanfang Li, MD, PhD
Dazhi Xu, MD, PhD
Yuanxiang Guan, MD
Zhiwei Zhou, MD, PhD
Publication date
01-04-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4981-6

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