Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2890
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
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).
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.
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.
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.
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).
High serum CEA levels in CRCLM patients were significantly associated with poor OS before and after LR surgery.
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.