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.

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.

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).

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. Cancer 2010. © 2010 American Cancer Society.

PMID: 20336782 [PubMed − as supplied by publisher] Source: National Library of Medicine.