Combined Evaluation of Preoperative Serum CEA and CA125 as an Independent Prognostic Biomarker in Patients with Early-Stage Cervical Adenocarcinoma

Genping Huang; Ruizhe Chen; Nanjia Lu; Qin Chen; Weiguo Lv; Baohua Li

doi:10.2147/OTT.S250614

Combined Evaluation of Preoperative Serum CEA and CA125 as an Independent Prognostic Biomarker in Patients with Early-Stage Cervical Adenocarcinoma

Onco Targets Ther. 2020 Jun 8:13:5155-5164. doi: 10.2147/OTT.S250614. eCollection 2020.

Authors

Genping Huang^#¹, Ruizhe Chen^#¹, Nanjia Lu¹, Qin Chen², Weiguo Lv^{1

3}, Baohua Li^{1

3}

Affiliations

¹ Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
² Department of Pathology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
³ Center of Uterine Cancer Diagnosis & Therapy of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: There is currently a lack of research on preoperative prognostic analysis of early-stage cervical adenocarcinoma (ADC). The purpose of our study was to clarify whether preoperative serum tumor-marker levels were of prognostic value in early-stage ADC.

Patients and methods: We performed a retrospective study of patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA1-IIA1 and pathology-proven invasive ADC. We evaluated the relationship between preoperative serum tumor-marker levels and clinicopathological characteristics, and identified the relative preoperative risk factors affecting disease-free survival (DFS) and overall survival (OS). The optimal cut-off point of meaningful tumor markers was determined by the analysis of receiver operating characteristics (ROC), and the accuracy of the results was evaluated by the area under the curve (AUC).

Results: Elevated carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), squamous cell carcinoma antigen (SCC-Ag), alpha-fetoprotein (AFP), carbohydrate antigen 153 (CA153) and carbohydrate antigen 199 (CA199) were associated with certain clinicopathologic features of early-stage ADC. The combination of elevated serum CEA and CA125 was significantly associated with FIGO stage, body mass index (BMI) and LNM. Kaplan-Meier survival curve and Cox regression analyses revealed that CEA and CA125 might have significant prognostic implications in early-stage ADC patients, and the combination of elevated serum CEA and CA125 served as an independent predictor of early-stage ADC. The optimal cut-off point of serum CA125 for prediction DFS and OS was 32.60 U/mL and of serum CEA were 2.85 ng/mL and 2.05 ng/mL, respectively. The AUC showed that serum CEA was a moderate predictor of OS.

Conclusion: The preoperative serum levels of CEA and CA125 might have significant prognostic implications in early-stage ADC patients. Combined preoperative serum CEA and CA125 levels independently predicted the prognosis of early-stage ADC.

Keywords: cancer antigen 125; carcinoembryonic antigen; prognosis; the early-stage cervical adenocarcinoma.

Grants and funding

This study was supported by Zhejiang Provincial Natural Science Foundation of China (Grant No. LY18H160004). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the paper.