Association Between Recurrence Rates of Colorectal Cancer and Carcinoembryonic Antigen Levels, Histopathological Features, Tumor-Infiltrating Lymphocytes, and Lymphatic Invasion at H. Adam Malik Central General Hospital, Medan
Keywords:
colorectal cancer recurrence, carcinoembryonic antigen, tumor-infiltrating lymphocytes, lymphovascular invasionAbstract
Introduction: In Indonesia, colorectal cancer ranks fourth in cancer incidence, with an estimated over 30,000 new cases each year. This study aims to investigate the association between colorectal cancer recurrence rates and CEA levels, histopathology, tumor-infiltrating lymphocytes, and lymphatic invasion at H. Adam Malik Central General Hospital, Medan. Methods: This cross-sectional study investigates the correlation between colorectal cancer recurrence and clinical parameters such as CEA levels, histopathology, TIL, and lymphatic invasion using retrospective data from patients at H. Adam Malik Central General Hospital in North Sumatra. Results: Out of 75 patients identified, 45 met the inclusion criteria. The study found significant relationships between recurrence and CEA levels (p=0.007), histopathological grade (p<0.001), and lymphovascular invasion (p=0.026), while tumor-infiltrating lymphocytes showed no significant correlation (p=0.358). Conclusion: Colorectal cancer recurrence are primarily shown in male patients with rectal and sigmoid tumors, predominantly adenocarcinoma at stage IIb. Significant CEA levels, moderate histological differentiation, tumor-infiltrating lymphocytes, and lymphovascular invasion were identified.
References
Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi:10.3322/caac.21660
Ferlay J, Colombet M, Soerjomataram I, et al. Cancer statistics for the year 2020: An overview. Int J Cancer. Published online April 5, 2021. doi:10.1002/ijc.33588
Jeong S, Nam TK, Jeong JU, et al. Postoperative carcinoembryonic antigen level has a prognostic value for distant metastasis and survival in rectal cancer patients who receive preoperative chemoradiotherapy and curative surgery: a retrospective multi-institutional analysis. Clin Exp Metastasis. 2016;33(8):809-816. doi:10.1007/s10585-016-9818-6
Konishi T, Shimada Y, Hsu M, et al. Association of Preoperative and Postoperative Serum Carcinoembryonic Antigen and Colon Cancer Outcome. JAMA Oncol. 2018;4(3):309-315. doi:10.1001/jamaoncol.2017.4420
Kim HG, Yang SY, Han YD, et al. Association of perioperative serum carcinoembryonic antigen level and recurrence in low-risk stage IIA colon cancer. PLOS ONE. 2021;16(6):e0252566. doi:10.1371/journal.pone.0252566
Aaltonen LA, Hamilton SR, World Health Organization, International Agency for Research on Cancer, eds. Pathology and Genetics of Tumours of the Digestive System. IARC Press ; Oxford University Press (distributor,); 2000.
Jiang HH, Zhang ZY, Wang XY, et al. Prognostic significance of lymphovascular invasion in colorectal cancer and its association with genomic alterations. World J Gastroenterol. 2019;25(20):2489-2502. doi:10.3748/wjg.v25.i20.2489
Cheong C, Shin JS, Suh KW. Prognostic value of changes in serum carcinoembryonic antigen levels for preoperative chemoradiotherapy response in locally advanced rectal cancer. World J Gastroenterol. 2020;26(44):7022-7035. doi:10.3748/wjg.v26.i44.7022
Duffy MJ, van Dalen A, Haglund C, et al. Tumour markers in colorectal cancer: European Group on Tumour Markers (EGTM) guidelines for clinical use. Eur J Cancer Oxf Engl 1990. 2007;43(9):1348-1360. doi:10.1016/j.ejca.2007.03.021
Galon J, Costes A, Sanchez-Cabo F, et al. Type, density, and location of immune cells within human colorectal tumors predict clinical outcome. Science. 2006;313(5795):1960-1964. doi:10.1126/science.1129139
Roxburgh CSD, McMillan DC. The role of the in situ local inflammatory response in predicting recurrence and survival in patients with primary operable colorectal cancer. Cancer Treat Rev. 2012;38(5):451-466. doi:10.1016/j.ctrv.2011.09.001
Richards CH, Roxburgh CSD, Powell AG, Foulis AK, Horgan PG, McMillan DC. The clinical utility of the local inflammatory response in colorectal cancer. Eur J Cancer Oxf Engl 1990. 2014;50(2):309-319. doi:10.1016/j.ejca.2013.09.008
Laghi L, Bianchi P, Miranda E, et al. CD3+ cells at the invasive margin of deeply invading (pT3-T4) colorectal cancer and risk of post-surgical metastasis: a longitudinal study. Lancet Oncol. 2009;10(9):877-884. doi:10.1016/S1470-2045(09)70186-X
Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683-691. doi:10.1136/gutjnl-2015-310912
Arnold M, Abnet CC, Neale RE, et al. Global Burden of 5 Major Types of Gastrointestinal Cancer. Gastroenterology. 2020;159(1):335-349.e15. doi:10.1053/j.gastro.2020.02.068
Hu K, Ding P, Wu Y, Tian W, Pan T, Zhang S. Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases. BMJ Open. 2019;9(10):e028461. doi:10.1136/bmjopen-2018-028461
Morgan E, Arnold M, Gini A, et al. Global burden of colorectal cancer in 2020 and 2040: incidence and mortality estimates from GLOBOCAN. Gut. 2023;72(2):338-344. doi:10.1136/gutjnl-2022-327736
Patel SG, May FP, Anderson JC, et al. Updates on Age to Start and Stop Colorectal Cancer Screening: Recommendations From the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2022;162(1):285-299. doi:10.1053/j.gastro.2021.10.007
US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(19):1965-1977. doi:10.1001/jama.2021.6238
Siegel RL, Miller KD, Goding Sauer A, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70(3):145-164. doi:10.3322/caac.21601
Viale PH. The American Cancer Society’s Facts & Figures: 2020 Edition. J Adv Pract Oncol. 2020;11(2):135-136. doi:10.6004/jadpro.2020.11.2.1
Liu X, Li J bin, Shi G, Guo R, Zhang R. Systematic review of single-incision versus conventional multiport laparoscopic surgery for sigmoid colon and rectal cancer. World J Surg Oncol. 2018;16(1):220. doi:10.1186/s12957-018-1521-4
Corley DA, Jensen CD, Marks AR, et al. Adenoma Detection Rate and Risk of Colorectal Cancer and Death. N Engl J Med. 2014;370(14):1298-1306. doi:10.1056/NEJMoa1309086
Ma H, Brosens LAA, Offerhaus GJA, Giardiello FM, de Leng WWJ, Montgomery EA. Pathology and genetics of hereditary colorectal cancer. Pathology (Phila). 2018;50(1):49-59. doi:10.1016/j.pathol.2017.09.004
Park JH, Watt DG, Roxburgh CSD, Horgan PG, McMillan DC. Colorectal Cancer, Systemic Inflammation, and Outcome: Staging the Tumor and Staging the Host. Ann Surg. 2016;263(2):326. doi:10.1097/SLA.0000000000001122
Dekker E, Tanis PJ, Vleugels JLA, Kasi PM, Wallace MB. Colorectal cancer. The Lancet. 2019;394(10207):1467-1480. doi:10.1016/S0140-6736(19)32319-0
Nagtegaal ID, Knijn N, Hugen N, et al. Tumor Deposits in Colorectal Cancer: Improving the Value of Modern Staging—A Systematic Review and Meta-Analysis. J Clin Oncol. 2017;35(10):1119-1127. doi:10.1200/JCO.2016.68.9091
Beom SH, Shin SJ, Kim CG, et al. Clinical Significance of Preoperative Serum Carcinoembryonic Antigen Within the Normal Range in Colorectal Cancer Patients Undergoing Curative Resection. Ann Surg Oncol. 2020;27(8):2774-2783. doi:10.1245/s10434-020-08256-5
Yang KM, Park IJ, Kim CW, Roh SA, Cho DH, Kim JC. The prognostic significance and treatment modality for elevated pre- and postoperative serum CEA in colorectal cancer patients. Ann Surg Treat Res. 2016;91(4):165-171. doi:10.4174/astr.2016.91.4.165
Park MS, Yi NJ, Son SY, et al. Histopathologic factors affecting tumor recurrence after hepatic resection in colorectal liver metastases. Ann Surg Treat Res. 2014;87(1):14-21. doi:10.4174/astr.2014.87.1.14
Facciorusso A, Di Maso M, Serviddio G, et al. Factors Associated With Recurrence of Advanced Colorectal Adenoma After Endoscopic Resection. Clin Gastroenterol Hepatol. 2016;14(8):1148-1154.e4. doi:10.1016/j.cgh.2016.03.017
Al-Sukhni E, Attwood K, Gabriel EM, LeVea CM, Kanehira K, Nurkin SJ. Lymphovascular and perineural invasion are associated with poor prognostic features and outcomes in colorectal cancer: A retrospective cohort study. Int J Surg. 2017;37:42-49. doi:10.1016/j.ijsu.2016.08.528
Kim S, Huh JW, Lee WY, et al. Lymphovascular invasion, perineural invasion, and tumor budding are prognostic factors for stage I colon cancer recurrence. Int J Colorectal Dis. 2020;35(5):881-885. doi:10.1007/s00384-020-03548-4
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Fawzan Mohammad, Adi Muradi Muhar, Edwin Saleh Siregar (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
