Predictive value of a serum tumor biomarkers scoring system for clinical stage II/III rectal cancer with neoadjuvant chemoradiotherapy

Table 1 Clinicopathological characteristics

Features	Median (IQR)
Pre-NCRT CEA	4.15 (2.18-10.07)
Pre-NCRT CA19-9	13.56 (7.80-25.40)
Age in yr	57.0 (50.0-66.5)
Sex
Male	150
Female	87
Pathological T stage
T0-2	118
T3-4	119
Pathological N stage
N0	177
N+	60
Pathological TNM stage
0	45
I	57
II	72
III	63
Pathological vascular invasion
Yes	13
No	224
Pathological lymphatic invasion
Yes	13
No	224
Pathological perineural invasion
Yes	41
No	196
Pathological CRM
Positive	8
Negative	229

NCRT: Neoadjuvant chemoradiotherapy; CEA: Carcinoembryonic antigen; CA19-9: Cancer antigen 19-9; TNM: Tumor, node and metastasis; CRM: Circumferential resection margin; IQR: Interquartile range.

Table 2 Univariate analysis of factors affecting the overall survival

Characteristics	HR (95%CI)	P value
Pre-NCRT CEA (< 3.55/> 3.55)	0.407 (0.185-0.893)	0.025
Pre-NCRT CA19-9 (< 19.01/> 19.01)	0.437 (0.225-0.849)	0.014
Sex (male/female)	0.478 (0.218-1.049)	0.066
Pathological TNM stage (0-I/II-III)	0.321 (0.141-0.732)	0.007
Pathological vascular invasion (absent/present)	0.556 (0.170-1.821)	0.332
Pathological lymphatic invasion (absent/present)	0.400 (0.141-1.136)	0.085
Pathological perineural invasion (absent/present)	0.534 (0.250-1.141)	0.105
Pathological CRM (negative/positive)	0.826 (0.198-3.449)	0.793
NSTB score (0-1/2)	0.416 (0.217-0.800)	0.009

NCRT: Neoadjuvant chemoradiotherapy; CEA: Carcinoembryonic antigen; CA19-9: Cancer antigen 19-9; TNM: Tumor, node and metastasis; CRM: Circumferential resection margin; NSTB: Novel serum tumor biomarker score.

Table 3 Univariate analysis of factors affecting disease-free survival

Characteristic	HR (95%CI)	P value
Pre-NCRT CEA (< 3.55/> 3.55)	0.391 (0.178-0.859)	0.019
Pre-NCRT CA19-9 (< 19.01/> 19.01)	0.413 (0.213-0.802)	0.009
Sex (male/female)	0.466 (0.213-1.023)	0.057
Pathological TNM stage (0-I/II-III)	0.302 (0.132-0.690)	0.005
Pathological vascular invasion (absent/present)	0.571 (0.175-1.863)	0.353
Pathological lymphatic invasion (absent/present)	0.435 (0.154-1.231)	0.117
Pathological perineural invasion (absent/present)	0.595 (0.279-1.265)	0.177
Pathological CRM (negative/positive)	0.657 (0.158-2.738)	0.564
NSTB score (0-1/2)	0.391 (0.203-0.751)	0.005

NCRT: Neoadjuvant chemoradiotherapy; CEA: Carcinoembryonic antigen; CA19-9: Cancer antigen 19-9; TNM: Tumor, node and metastasis; CRM: Circumferential resection margin; NSTB: Novel serum tumor biomarker score.

Table 4 Multivariate analysis of factors affecting the overall survival

Characteristic	Multivariate analysis
	Model 1		Model 2
	HR (95%CI)	P value	HR (95%CI)	P value
Pre-NCRT CEA (< 3.55/> 3.55)	0.529 (0.232-1.205)	0.130
Pre-NCRT CA19-9 (< 19.01/> 19.01)	0.604 (0.300-1.215)	0.158
Pathological TNM stage (0-I/II-III)	0.373 (0.162-0.859)	0.020	0.363 (0.158-0.837)	0.017
NSTB score (0-1/2)			0.485 (0.251-0.940)	0.032

Model 1: Including pre-neoadjuvant chemoradiotherapy (NCRT) carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA19-9) into multivariate analysis, not including novel serum tumor biomarker (NSTB) score; Model 2: Including NSTB score into multivariate analysis, not including pre-NCRT CEA and CA19-9. NCRT: Neoadjuvant chemoradiotherapy; CEA: Carcinoembryonic antigen; CA19-9: Cancer antigen 19-9; NSTB: Novel serum tumor biomarker score; TNM: Tumor, node and metastasis.

Table 5 Multivariate analysis of factors affecting the disease-free survival

Characteristic	Multivariate analysis
	Model 1		Model 2
	HR (95%CI)	P value	HR (95%CI)	P value
Pre-NCRT CEA (< 3.55/> 3.55)	0.512 (0.226-1.162)	0.109
Pre-NCRT CA19-9 (< 19.01/> 19.01)	0.570 (0.284-1.141)	0.112
Pathological TNM stage (0-I/II-III)	0.350 (0.152-0.806)	0.014	0.342 (0.149-0.786)	0.012
NSTB score (0-1/2)			0.453 (0.234-0.877)	0.019

Model 1: Including pre-neoadjuvant chemoradiotherapy (NCRT) carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA19-9) into multivariate analysis, not including novel serum tumor biomarker (NSTB) score; Model 2: Including NSTB score into multivariate analysis, not including pre-NCRT CEA and CA19-9. NCRT: Neoadjuvant chemoradiotherapy; CEA: Carcinoembryonic antigen; CA19-9: Cancer antigen 19-9; NSTB: Novel serum tumor biomarker score; TNM: Tumor, node and metastasis.