Circulating tumor cell count and serum CEA mRNA level predict postoperative recurrence of digestive tract cancer

Guanglin Zhang; Xiancun Fang; Chunlong Liu; Fei Han

Circulating tumor cell count and serum CEA mRNA level predict postoperative recurrence of digestive tract cancer

Am J Transl Res. 2021 Aug 15;13(8):9514-9521. eCollection 2021.

Authors

Guanglin Zhang¹, Xiancun Fang², Chunlong Liu³, Fei Han⁴

Affiliations

¹ Department of Gastroenterology, Shouguang People's Hospital Shouguang, Shandong Province, China.
² Department of General Surgery, Shouguang People's Hospital Shouguang, Shandong Province, China.
³ Department of Gastroenterology, Zibo Hospital, 960 Hospital of PLA Zibo, Shandong Province, China.
⁴ Department of Oncology, Ji'nan Sixth People's Hospital Ji'nan, Shandong Province, China.

PMID: 34540073
PMCID: PMC8430058

Abstract

Objective: To evaluate the predictive value of circulating tumor cell count (CTC) and serum carcinoembryonic antigen (CEA) mRNA levels in postoperative recurrence of digestive tract cancer.

Methods: A total of 52 patients with digestive tract cancer who underwent radical resection in our hospital were divided into a recurrent group (n=18) and a non-recurrent group (n=34). The CTC and CEA mRNA levels of the two groups were compared one day before the operation. Pearson correlation analysis was used to analyze the correlation between CTC and CEA mRNA levels. The curve of subjects' working characteristics was used to analyze the predictive value of the serum CTC and the level of CEA mRNA in postoperative recurrence of digestive tract cancer. The correlation of CTC and CEA mRNA expression with different age, sex, cancer type and TNM stage was further analyzed.

Results: CTC and CEA mRNA levels in the recurrent group were higher than those in the non-recurrent group (P<0.05). CTC was positively correlated with the CEA mRNA level by Pearson correlation (r=0.609, P=0.000). ROC curve showed that the area under the curve of CEA mRNA, CTC and combined test in predicting postoperative recurrence of digestive tract cancer were 0.912, 0.831 and 0.965 respectively. The area under the curve of the combined test and CEA mRNA level was significantly higher than that of CTC (Z=3.794, P=0.000; Z=2.001, P=0.045). There was no significant difference in the area under the curve between combined detection and CEA mRNA (Z=1.437 and P=0.151). There was no significant difference in CTC and CEA mRNA levels among patients with different sex, age, body weight, differentiation degree and histological type (P>0.05). The CTC and CEA mRNA levels of patients in stage lll and lV were higher than those in stage l and ll and the difference was statistically significant (P<0.05). By Spearman rank correlation analysis, it was found that CTC and CEA mRNA levels were positively correlated with the TNM stage (r=0.532, 0.712, P<0.05).

Conclusion: levels of CTC and serum CEA mRNA have a certain value in predicting postoperative recurrence of digestive tract cancer and their expression is closely related to TNM stage. Clinical diagnosis of both of them can improve the diagnostic efficiency of predicting postoperative recurrence.

Keywords: Circulating tumor cell count; digestive tract cancer; mRNA; recurrence; serum carcinoembryonic antigen.