Text/Yangcheng Evening News All Media Reporter Xue Renzheng
Correspondent Jian Wenyang Dai Xi’an
Photo/Provided by the interviewee
Recently, the No. The important research results of Luo Yanxin and Yu Huichuan’s team from the Sixth Hospital in the field of rectal cancer clinical diagnosis and treatment “CurrentSurveillanceAfterTreatmentisNotSufficientforPatientsWithRectalCancerWithNegativeBaselineCEA” (the current rectal cancer post-treatment monitoring program is insufficient in patients with normal baseline CEA) was published in the official journal of the National Comprehensive Cancer Network (NCCN) in the United States JournaloftheNationalComprehensiveCancerNetwork (JNCCN, IF=11.908) is published online in the form of original papers. Yu Huichuan of the Institute of Gastroenterology of the hospital is the corresponding author of the paper, and Shen Ding, a doctoral student, is the first author of the paper.
JNCCN published online the results of Luo Yanxin and Yu Huichuan’s research team from Zhongshan Sixth Hospital
Carcinoembryonic antigen is of great importance The clinical value of
Carcinoembryonic antigen (CEA) is a tumor-associated antigen firstly extracted from colon cancer and embryonic tissues by Gold and Freedman in 1965. CEA is easy to detect in human organs, tissues and various body fluids, and the detection has the advantages of non-invasiveness, standardization and low cost. A large number of clinical practices have proved that CEA, as a broad-spectrum tumor marker, has important clinical value in the evaluation of curative effect and disease monitoring of various tumors such as digestive tract tumors, urinary tract tumors, lung cancer, ovarian cancer and breast cancer. The normal reference normal value of serum CEA is: 0-5ug/L.
The nurse in the blood collection room of Zhongshan No. 6 Hospital collects blood for patients (photographed by Zhang Yuanquan)
NCCN is an American An academic organization composed of many top cancer centers, the NCCN guidelines issued by it have become the most widely used clinical guidelines in global oncology clinical practice, and have been recognized and followed by clinicians around the world. According to the recommendations of authoritative colorectal cancer clinical guidelines at home and abroad, including the NCCN guidelines, the detection of CEA is regarded as one of the most important initial means to monitor the recurrence of colorectal cancer after surgery. Elevated CEA during follow-up can often provide early warning The tumor recurred after operation, and further examinations such as colonoscopy or imaging were performed to confirm the diagnosis.
NCCN Guidelines for Post-treatment Surveillance in Rectal Cancer (NCCN 2022 V1, REC-11)
However, In the course of clinical practice, the team members found that for rectal cancer patients with normal CEA before surgery, the effect of preliminarily judging tumor recurrence and metastasis by the increase of postoperative CEA is often not ideal. Therefore, the research team conducted a longitudinal cohort study to address this issue.
A longitudinal cohort study conducted by the Zhongshan Sixth Hospital team (Shen et al. JNCCN 2022)
Latest research The results will help patients’ prognosis
The results of the study showed that for patients with rectal cancer with normal baseline CEA, the sensitivity of CEA to monitor tumor recurrence was significantly lower than that of patients with elevated baseline CEA. At the same time, CEA combined with carbohydrate antigen CA19-9 can significantly improve its sensitivity in recurrence monitoring of patients with normal CEA at baseline compared with CEA alone. Therefore, current CEA-based postoperative follow-up protocols are insufficient in rectal cancer patients with normal baseline CEA. The research team improved the postoperative follow-up plan for rectal cancer in the NCCN guidelines, and proposed the “CEA stratified monitoring plan”, which recommended the corresponding follow-up monitoring plan for patients with different CEA baseline values.
The CEA stratified monitoring scheme after rectal cancer treatment proposed by the Zhongshan Sixth Hospital team (Shen et al. JNCCN 2022)
In addition, the research team also discovered and defined a CEA-turntumor (CEA-turntumor), about one-quarter of patients with recurrent rectal cancer, had CEA-turntumor, and its main characteristics included baseline CEA negative before treatment and CEA positive at relapse after treatment. Patients with recurrent rectal cancer with CEA transformation exhibited more malignant tumor biology and poorer long-term survival outcomes.
CEA-transformed tumors have worse long-term survival outcomes (Shen et al. JNCCN 2022)
Group photo of Luo Yanxin and Yu Huichuan team from Zhongshan Sixth Hospital