Serum sE-selectin levels and carcinoembryonic antigen mRNA-expressing cells in peripheral blood as prognostic factors in colorectal cancer patients

Cancer. 2010 Jun 15;116(12):2913-21. doi: 10.1002/cncr.25094.


Background: This study analyzed the possible prognostic value of presurgical serum soluble (s)E-selectin levels and/or carcinoembryonic antigen (CEA) mRNA positivity in predicting the disease-free survival of colorectal cancer (CRC) patients.

Methods: CEA mRNA (obtained from blood-borne cells by reverse transcriptase-polymerase chain reaction [RT-PCR]), tumor necrosis factor-alpha (TNF-alpha), and sE-selectin levels were analyzed in blood samples obtained from 78 patients with primary (n = 62) or recurrent (n = 16) CRC, 40 patients with benign colorectal (CR) diseases, and 78 controls.

Results: CEA mRNA positivity by RT-PCR was significantly associated with advanced stage (P < .05). Median baseline sE-selectin levels were higher in patients with CRC (43 ng/mL) compared with controls (36 ng/mL) or patients with benign CR diseases (31 ng/mL, P < .001). These were significantly associated with CEA mRNA positivity by RT-PCR (P < .05). Multivariate analysis by forward stepping showed that elevated TNF-alpha (P = .001) and CEA mRNA positivity by RT-PCR (P = .0001) were independent predictors of elevated baseline sE-selectin levels. Positive presurgical sE-selectin levels were associated with an increased recurrence rate compared with patients with low levels of this molecule (P < .001). Positivity for both CEA mRNA and sE-selectin had a negative prognostic impact, with a 5-year recurrence-free survival rate of 51% compared with 95% of patients with negative parameters (P < .05).

Conclusions: Detection of presurgical serum sE-selectin levels and CEA mRNA-positive blood-borne cells in CRC patients might provide useful prognostic information in terms of recurrence-free survival, either alone or in combination, and may help in the choice of more aggressive treatment and/or more strict follow-up procedures in high-risk patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers, Tumor / blood
  • Carcinoembryonic Antigen / blood
  • Carcinoembryonic Antigen / genetics*
  • Colorectal Neoplasms / blood*
  • Disease-Free Survival
  • E-Selectin / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • RNA, Messenger / blood
  • Reverse Transcriptase Polymerase Chain Reaction


  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • E-Selectin
  • RNA, Messenger