Kolon Kanserinde Karsinoembriyonik Antijen ile Prognoz Arasındaki İlişki

Öz

Giriş: Karsinoembriyonik antijen (CEA), gastrointestinal kanserler için bir biyobelirteç olarak hizmet eder ve yüksek seviyeleri genellikle kötü prognoza işaret eder. Özellikle, CEA seviyelerinin 10 µg/L üzerinde olması olumsuz sonuçlarla ilişkilendirilirken, 20 µg/L’yi aşan değerler metastatik hastalıkla ilişkilidir. Bu çalışma, preoperatif CEA düzeylerinin yüksekliği ile kolon kanseri hastalarının sağkalımı ve prognozu arasındaki ilişkiyi kurumumuzda araştırmayı amaçlamaktadır. Gereç ve Yöntemler: Bu çalışma, 2012-2022 yılları arasında ***’de ameliyat edilen kolon kanseri hastalarını içeren tek merkezli, retrospektif bir analiz olarak tasarlanmıştır. Hastalar preoperatif CEA seviyelerine göre üç gruba ayrılmıştır: 3-10 µg/L (düşük-yüksek), 10-20 µg/L (orta-yüksek) ve 20 µg/L üzeri (çok yüksek). Çalışmada demografik veriler, patolojik özellikler ve sağkalım sonuçları bu gruplar arasında karşılaştırılmıştır. Sonuç: Çalışmaya 124’ü erkek, 102’si kadın olmak üzere toplam 226 hasta dahil edilmiştir ve hastaların ortalama yaşı 61’dir. Analizlerde TNM ve patolojik evreler açısından gruplar arasında anlamlı bir fark saptanmamıştır. Bununla birlikte, yüksek CEA seviyeleri anlamlı şekilde artmış venöz, perinöral ve lenfatik invazyonla ilişkilendirilmiştir. Lokal, paraaortik ve peritoneal nüks oranları gruplar arasında anlamlı fark göstermezken, karaciğer metastazı birinci grupta daha sık gözlenmiştir. Tartışma: Bulgular, yüksek preoperatif CEA düzeyleri ile kolon kanseri hastalarında artmış lenfovasküler ve perinöral invazyon riski arasında anlamlı bir ilişki olduğunu göstermektedir. Bu ilişki, yüksek CEA düzeyine sahip hastalar için daha yoğun tedavi rejimlerinin, örneğin yoğun kemoterapi veya radyoterapinin, bireyselleştirilmiş olarak uygulanabileceğini göstermektedir.

Anahtar Kelimeler

• CEA
• Kolon Kanseri
• Biyobelirteç
• Prognoz

The Relationship Between Carcinoembryonic Antigen and Prognosis in Colon Cancer

Öz

Introduction: Carcinoembryonic antigen(CEA) serves as a biomarker for gastrointestinal cancers, with high levels often indicating a poor prognosis. Specifically, CEA levels above 10 µg/L are associated with unfavorable outcomes, and those exceeding 20 µg/L are linked to metastatic disease. This investigation aims to explore the relationship between elevated preoperative CEA levels and the survival and prognosis of colon cancer patients at our institution. Materials and Methods: This study was designed as a single-center, retrospective analysis involving colon cancer patients who underwent surgery at *** from 2012 to 2022. Patients were stratified based on preoperative CEA levels into three groups: 3-10 µg/L (low-high), 10-20 µg/L (moderately high), and over 20 µg/L (very high). The study compared demographic data, pathological features, and survival outcomes across these groups. Results: The study included 226 patients, 124 males and 102 females, with an average age of 61 years. Analysis revealed no significant difference in TNM and pathological stages among the groups. Notably, higher CEA levels were significantly correlated with increased instances of venous, perineural and lymphatic invasion. The occurrence of local, para-aortic, and peritoneal recurrences did not significantly differ across the groups, although liver metastasis was more prevalent in the first group. Discussion: The findings highlight a significant link between high preoperative CEA levels and an increased risk of lymphovascular and perineural invasion in colon cancer patients. This association underscores the potential for tailoring more intensive treatment regimens for patients with elevated CEA levels,including the possibility of enhanced chemotherapy or radiotherapy.

Anahtar Kelimeler

• CEA
• Colon Cancer
• Biomarker
• Prognosis.

Kaynakça

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