Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2023; 15(12): 2890-2906
Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2890
Prognostic role of serum carcinoembryonic antigen in patients receiving liver resection for colorectal cancer liver metastasis: A meta-analysis
Fan Tang, Cheng-Wen Huang, Zhi-Hong Tang, Shao-Long Lu, Tao Bai, Qing Huang, Xing-Zhi Li, Bin Zhang, Fei-Xiang Wu
Fan Tang, Cheng-Wen Huang, Zhi-Hong Tang, Shao-Long Lu, Tao Bai, Qing Huang, Xing-Zhi Li, Bin Zhang, Fei-Xiang Wu, Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Fei-Xiang Wu, Key Laboratory of High-Incidence-Tumor Prevention & Treatment, Ministry of Education, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Tang F and Huang CW contributed equally to this work. Tang F, Huang CW, and Wu FX contributed to the conceptualization of this study; Tang F, Huang CW, Li XZ, and Zhang B involved in the methodology and formal analysis of this article; Tang F and Huang CW participated in the investigation of this research; Bai T, Huang Q, and Wu FX took part in the validation of this manuscript; Tang ZH and Wu FX involved in the software of this study; Tang F and Huang CW participated in the writing - original draft preparation of this article; all authors contributed to the writing - review and editing of this manuscript; Tang ZH and Lu SL took part in the resources and data curation of this study; Wu FX contributed to the supervision of this article; and all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei-Xiang Wu, DSc, Doctor, Professor, Researcher, Surgeon, Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. wufeixiang@gxmu.edu.cn
Received: August 2, 2023
Peer-review started: August 2, 2023
First decision: October 20, 2023
Revised: November 3, 2023
Accepted: November 28, 2023
Article in press: November 28, 2023
Published online: December 27, 2023
Processing time: 147 Days and 10.5 Hours
ARTICLE HIGHLIGHTS
Research background

Carcinoembryonic antigen (CEA), also known as CD66e, is a glycoprotein consisting of about 100 amino acid residues, produced and secreted by gastrointestinal epithelial cells, and it is one of the most widely used tumor markers worldwide. It had been reported that the initial level of CEA was closely related to the prognosis of colorectal cancer (CRC) patients after liver resection (LR).

Research motivation

This paper explored whether serum CEA in CRC liver metastasis (CRCLM) patients receiving LR played a significant predictive and prognostic role before and after surgery by summarizing currently available research data, so as to provide a scientific basis for further improving the prognosis in CRCLM patients.

Research objectives

This object of this paper is to explore whether serum CEA in CRCLM patients receiving LR played a significant predictive and prognostic role before and after surgery by summarizing currently available research data, so as to provide a scientific basis for further improving the prognosis in CRCLM patients.

Research methods

PubMed, Embase, Cochrane and Web of Science were searched with a time frame until February 27, 2023. The retrieved studies were imported into Endnote X9, and then, duplicate references were excluded automatically by the software and manually. After literature screening was completed, an Excel data extraction form specific to this study was developed to summarize the information on the included articles. The data were pooled and analyzed using Stata 16.0.

Research results

This study included 36 studies involving a total of 11143 CRCLM patients. The results showed that a high pre-LR serum CEA level was correlated with poor overall survival (OS) [hazard ratio (HR) = 1.61, 95% confidence interval (CI): 1.49-1.75, P < 0.001] and recurrence-free survival (RFS) (HR = 1.27, 95%CI: 1.11-1.45, P < 0.001) in CRCLM patients. A high post-LR serum CEA level predicted poor OS (HR = 2.66, 95%CI: 2.10-3.38, P < 0.001).

Research conclusions

High serum CEA levels in CRCLM patients were significantly associated with poor OS before and after LR surgery.

Research perspectives

Regarding postoperative serum CEA predicting disease-free survival (DFS) and RFS, there were only two studies on each of them, so the evidence obtained so far in this study can only suggest that there may be potential for postoperative serum CEA to predict DFS and RFS in CRCLM patients, which needs to be confirmed by more future studies.