Retrospective Cohort Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2019; 25(33): 4945-4958
Published online Sep 7, 2019. doi: 10.3748/wjg.v25.i33.4945
Prognostic value of preoperative carcinoembryonic antigen/tumor size in rectal cancer
Du Cai, Zeng-Hong Huang, Hui-Chuan Yu, Xiao-Lin Wang, Liang-Liang Bai, Guan-Nan Tang, Shao-Yong Peng, Ying-Jie Li, Mei-Jin Huang, Guang-Wen Cao, Jian-Ping Wang, Yan-Xin Luo
Du Cai, Zeng-Hong Huang, Hui-Chuan Yu, Xiao-Lin Wang, Liang-Liang Bai, Guan-Nan Tang, Shao-Yong Peng, Ying-Jie Li, Jian-Ping Wang, Yan-Xin Luo, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease (Supported by National Key Clinical Discipline), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
Du Cai, Zeng-Hong Huang, Shao-Yong Peng, Mei-Jin Huang, Jian-Ping Wang, Yan-Xin Luo, Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
Zeng-Hong Huang, Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, Sacramento, CA 95817, United States
Guang-Wen Cao, Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
Author contributions: Cai D and Huang ZH contributed equally to this paper. Luo YX, Wang JP, Cao GW, and Huang MJ designed the research; Cai D and Huang ZH analyzed the data and drafted the article; Yu HC and Luo YX revised the article; Bai LL, Tang GN, Peng SY, and Li YJ collected and collated the data.
Supported by the National Basic Research Program of China (973 Program) (No. 2015CB554001, JW), the National Natural Science Foundation of China (No. 81972245, YL; No. 81902877, HY), the Natural Science Fund for Distinguished Young Scholars of Guangdong Province (No. 2016A030306002, YL), the Tip-top Scientific and Technical Innovative Youth Talents of Guangdong special support program (No. 2015TQ01R454, YL), the Project 5010 of Clinical Medical Research of Sun Yat-sen University-5010 Cultivation Foundation (No. 2018026, YL), the Natural Science Foundation of Guangdong Province (No. 2016A030310222, HY; No. 2018A0303130303, HY), the Program of Introducing Talents of Discipline to Universities, and National Key Clinical Discipline (2012).
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Sixth Affiliated Hospital, Sun Yat-sen University.
Informed consent statement: Patients were not required to provide informed consent for the study because the analysis used anonymous clinical data.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yan-Xin Luo, MA, MD, PhD, Associate Professor, Chief Doctor, Doctor, Surgical Oncologist, Department of Colorectal Surgery, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou 510655, Guangdong Province, China. luoyx25@mail.sysu.edu.cn
Telephone: +86-13826190263 Fax: +86-20-38254221
Received: March 12, 2019
Peer-review started: March 12, 2019
First decision: March 27, 2019
Revised: April 4, 2019
Accepted: May 18, 2019
Article in press: May 18, 2019
Published online: September 7, 2019
Processing time: 180 Days and 22.9 Hours
Core Tip

Core tip: This is a retrospective study that sought to evaluate the prognostic value of carcinoembryonic antigen (CEA)/tumor size in rectal cancer, which may better reflect the tumor malignancy. Maximally selected rank statistics identified an optimal cutoff point of 2.429 ng/mL per cm for CEA/tumor size. Kaplan-Meier curves showed a significant reduction in the 5-year overall survival and disease-free survival in the high CEA/tumor size group. Univariate and multivariate analyses identified CEA/tumor size as an independent prognostic factor for stage I to III rectal cancer.