Aim: The objectives of this study were to correlate elevations in plasma CEA levels with the extent of tissue CEA and determine the association of clinicopathological features with tissue CEA in primary tumours in Uganda.
Introduction: Circulating levels of carcinoembryonic antigen (CEA)
are widely accepted after primary tumour resection to monitor tumour recurrence
and this marker has proved to be useful in the management of colorectal cancer.
In Uganda and most parts of the world, carcinoembryonic antigen (CEA) is the
most widely used tumour marker. This marker monitors tumour recurrence and is
useful in the management of colorectal cancer (CRC). The aim of this study was
to correlate elevations in plasma CEA levels with the extent of tissue CEA and
determine the association of clinicopathological features with tissue CEA in
Ugandan colorectal tumours. Preoperative
elevation of CEA, and the degree of elevation, is associated with an increased
risk of recurrence and decreased long-term survival.
Methodology: A total of 119 patients with colorectal cancer
specimens from September 2019 to September 2021 were recruited from four
hospitals in central Uganda. A preoperative blood sample and the corresponding
formalin fixed paraffin embedded tissue block were obtained from all
participants. Data was abstracted from the clinical patients’ files on age,
sex, stage, grade and topography of CRC. Haematoxylin and eosin sections were
prepared to determine the histopathological subtype, grade, and lymphovascular
invasion status. The plasma CEA levels were determined and the tissue CEA
expression was detected using the indirect immunoperoxidase method which used
monoclonal antibody CEA, DAKO Agilent USA< Clone I17 and reference IR622.
Pearson chi-square test was used to assess the association between CEA
expression and demographic and histopathological variables. Analysis of
variance (ANOVA) was used to compare average plasma CEA levels (ng/ml) to
tissue CEA intensities. Results: There were 31.4% CRC tissues in stage IV that
stained positively for CEA compared to stage I (p=0.0101). Compared to 73.4%
with grade II CRC which stained positively for CEA, there were 15.2% of CRC
tissues with grade I that stained positively for CEA (p=0.0000). A positive
correlation was found between the CRC tissue CEA and grade of CRC (r=+0.2204)
and this reached statistical significance (p=0.0232). There was no relation
between preoperative plasma CEA level and the CEA in the CRC tissue.
Conclusions: This study showed a significant correlation between
the grade of CRC and CRC CEA tissue expression. A higher incidence of lymph
node metastasis is associated with a poorly differentiated CRC and a higher CRC
tissue CEA expression. There was no correlation found between preoperative
plasma CEA and tissue CEA. The study finding suggests a poorer prognosis for
patients expressing high levels of CEA in their colorectal cancer tissue in
Uganda.
Author (s) Details
Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka,
Uganda, Department of Surgery, Faculty of Health Sciences, Equator University
for Science and Technology, Masaka, Uganda, Department of Surgery, Faculty of
Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and
Department of Pathology, School of Biomedical Sciences, College of Health
Sciences, Makerere University, Kampala, Uganda.
Julius Kiwanuka
Department of Epidemiology and Biostatistics, School of Public
Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Henry Wabinga
Department of Pathology, Faculty of Medicine, Gulu University,
Gulu, Uganda.
Michael Odida
Department of Pathology, School of Biomedical Sciences, College of
Health Sciences, Makerere University, Kampala, Uganda and Department of
Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda.
Please see the book here:- https://doi.org/10.9734/bpi/acmms/v1/2819
No comments:
Post a Comment