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The combination of preoperative serum C-reactive protein and carcinoembryonic antigen is a useful prognostic factor in patients with esophageal squamous cell carcinoma: a combined ROC analysis.

Huang Y, Liu JS, Feng JF - Onco Targets Ther (2015)

Bottom Line: Patients with COCC ≤8.0 had a significantly better CSS than patients with COCC >8.0 (53.1% vs 15.3%, P<0.001).In addition, the area under the curve (AUC) was 0.722 for COCC, 0.645 for CRP, and 0.618 for CEA, indicating that COCC was superior to CRP or CEA for CSS prediction.We conclude that COCC was superior to CRP or CEA as a more precise prognostic factor in patients with ESCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.

ABSTRACT

Background: The prognostic value of inflammatory index in esophageal cancer (EC) has not been established. In the present study, therefore, we initially evaluated a novel prognostic system, named the COCC (COmbination of C-reactive protein [CRP] and carcinoembryonic antigen [CEA]), for making a prognosis in patients with esophageal squamous cell carcinoma (ESCC).

Methods: A total of 327 patients with ESCC between January 2006 and December 2008 were included in this retrospective study. The COCC was calculated by combined CRP and CEA according to the logistic equation. The Kaplan-Meier method was used to calculate the cancer-specific survival (CSS), and the difference was assessed by the log-rank test. Cox regression analyses were performed to evaluate the prognostic factors.

Results: In our study, COCC was defined as CRP +0.71 CEA according to the logistic equation. Receiver operating characteristic curves for CSS prediction were plotted to verify the optimum cutoff points for CRP, CEA, and COCC, which were 9.8 mg/L, 4.2 ng/mL, and 8.0, respectively. Patients with COCC ≤8.0 had a significantly better CSS than patients with COCC >8.0 (53.1% vs 15.3%, P<0.001). Multivariate analysis revealed that COCC was an independent prognostic factor in patients with ESCC (P=0.006). In addition, the area under the curve (AUC) was 0.722 for COCC, 0.645 for CRP, and 0.618 for CEA, indicating that COCC was superior to CRP or CEA for CSS prediction.

Conclusion: The COCC is an independent prognostic factor in patients with ESCC. We conclude that COCC was superior to CRP or CEA as a more precise prognostic factor in patients with ESCC.

No MeSH data available.


Related in: MedlinePlus

ROC curves for CSS prediction.Notes: An ROC curve plots the sensitivity on the y-axis against one minus the specificity on the x-axis. A diagonal line at 45°, known as the line of chance, would result from a test that allocated subjects randomly. ROC curves for CSS were plotted to verify the optimum cutoff points for CRP, CEA, and COCC, which were 9.8 mg/L, 4.2 ng/mL, and 8.0, respectively. The AUC was 0.722 (95% CI: 0.666–0.778, P<0.001) for COCC, 0.645 (95% CI: 0.586–0.705, P<0.001) for CRP, and 0.618 (95% CI: 0.557–0.679, P<0.001) for CEA.Abbreviations: CRP, C-reactive protein; CEA, carcinoembryonic antigen; COCC, COmbination of CRP and CEA; ROC, receiver operating characteristic; CSS, cancer-specific survival; AUC, area under the curve.
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f2-ott-8-795: ROC curves for CSS prediction.Notes: An ROC curve plots the sensitivity on the y-axis against one minus the specificity on the x-axis. A diagonal line at 45°, known as the line of chance, would result from a test that allocated subjects randomly. ROC curves for CSS were plotted to verify the optimum cutoff points for CRP, CEA, and COCC, which were 9.8 mg/L, 4.2 ng/mL, and 8.0, respectively. The AUC was 0.722 (95% CI: 0.666–0.778, P<0.001) for COCC, 0.645 (95% CI: 0.586–0.705, P<0.001) for CRP, and 0.618 (95% CI: 0.557–0.679, P<0.001) for CEA.Abbreviations: CRP, C-reactive protein; CEA, carcinoembryonic antigen; COCC, COmbination of CRP and CEA; ROC, receiver operating characteristic; CSS, cancer-specific survival; AUC, area under the curve.

Mentions: The ROC curves for survival prediction (CSS) were plotted to verify the optimum cutoff points for CRP, CEA, and COCC, which were 9.8 mg/L, 4.2 ng/mL, and 8.0, respectively (Figure 2). The patients were then divided into two groups for further analysis (patients with COCC ≤8.0 and patients with COCC >8.0). In our study, there were 196 (59.9%) patients with COCC ≤8.0 and 131 (40.1%) patients with COCC >8.0. Our study demonstrated that COCC was associated with tumor length (P=0.002), differentiation (P=0.035), T stage (P<0.001), and N stage (P=0.016) (Table 2). In addition, our study showed that the values of COCC were higher in patients with high T stage and N stage (Figure 3).


The combination of preoperative serum C-reactive protein and carcinoembryonic antigen is a useful prognostic factor in patients with esophageal squamous cell carcinoma: a combined ROC analysis.

Huang Y, Liu JS, Feng JF - Onco Targets Ther (2015)

ROC curves for CSS prediction.Notes: An ROC curve plots the sensitivity on the y-axis against one minus the specificity on the x-axis. A diagonal line at 45°, known as the line of chance, would result from a test that allocated subjects randomly. ROC curves for CSS were plotted to verify the optimum cutoff points for CRP, CEA, and COCC, which were 9.8 mg/L, 4.2 ng/mL, and 8.0, respectively. The AUC was 0.722 (95% CI: 0.666–0.778, P<0.001) for COCC, 0.645 (95% CI: 0.586–0.705, P<0.001) for CRP, and 0.618 (95% CI: 0.557–0.679, P<0.001) for CEA.Abbreviations: CRP, C-reactive protein; CEA, carcinoembryonic antigen; COCC, COmbination of CRP and CEA; ROC, receiver operating characteristic; CSS, cancer-specific survival; AUC, area under the curve.
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Related In: Results  -  Collection

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f2-ott-8-795: ROC curves for CSS prediction.Notes: An ROC curve plots the sensitivity on the y-axis against one minus the specificity on the x-axis. A diagonal line at 45°, known as the line of chance, would result from a test that allocated subjects randomly. ROC curves for CSS were plotted to verify the optimum cutoff points for CRP, CEA, and COCC, which were 9.8 mg/L, 4.2 ng/mL, and 8.0, respectively. The AUC was 0.722 (95% CI: 0.666–0.778, P<0.001) for COCC, 0.645 (95% CI: 0.586–0.705, P<0.001) for CRP, and 0.618 (95% CI: 0.557–0.679, P<0.001) for CEA.Abbreviations: CRP, C-reactive protein; CEA, carcinoembryonic antigen; COCC, COmbination of CRP and CEA; ROC, receiver operating characteristic; CSS, cancer-specific survival; AUC, area under the curve.
Mentions: The ROC curves for survival prediction (CSS) were plotted to verify the optimum cutoff points for CRP, CEA, and COCC, which were 9.8 mg/L, 4.2 ng/mL, and 8.0, respectively (Figure 2). The patients were then divided into two groups for further analysis (patients with COCC ≤8.0 and patients with COCC >8.0). In our study, there were 196 (59.9%) patients with COCC ≤8.0 and 131 (40.1%) patients with COCC >8.0. Our study demonstrated that COCC was associated with tumor length (P=0.002), differentiation (P=0.035), T stage (P<0.001), and N stage (P=0.016) (Table 2). In addition, our study showed that the values of COCC were higher in patients with high T stage and N stage (Figure 3).

Bottom Line: Patients with COCC ≤8.0 had a significantly better CSS than patients with COCC >8.0 (53.1% vs 15.3%, P<0.001).In addition, the area under the curve (AUC) was 0.722 for COCC, 0.645 for CRP, and 0.618 for CEA, indicating that COCC was superior to CRP or CEA for CSS prediction.We conclude that COCC was superior to CRP or CEA as a more precise prognostic factor in patients with ESCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.

ABSTRACT

Background: The prognostic value of inflammatory index in esophageal cancer (EC) has not been established. In the present study, therefore, we initially evaluated a novel prognostic system, named the COCC (COmbination of C-reactive protein [CRP] and carcinoembryonic antigen [CEA]), for making a prognosis in patients with esophageal squamous cell carcinoma (ESCC).

Methods: A total of 327 patients with ESCC between January 2006 and December 2008 were included in this retrospective study. The COCC was calculated by combined CRP and CEA according to the logistic equation. The Kaplan-Meier method was used to calculate the cancer-specific survival (CSS), and the difference was assessed by the log-rank test. Cox regression analyses were performed to evaluate the prognostic factors.

Results: In our study, COCC was defined as CRP +0.71 CEA according to the logistic equation. Receiver operating characteristic curves for CSS prediction were plotted to verify the optimum cutoff points for CRP, CEA, and COCC, which were 9.8 mg/L, 4.2 ng/mL, and 8.0, respectively. Patients with COCC ≤8.0 had a significantly better CSS than patients with COCC >8.0 (53.1% vs 15.3%, P<0.001). Multivariate analysis revealed that COCC was an independent prognostic factor in patients with ESCC (P=0.006). In addition, the area under the curve (AUC) was 0.722 for COCC, 0.645 for CRP, and 0.618 for CEA, indicating that COCC was superior to CRP or CEA for CSS prediction.

Conclusion: The COCC is an independent prognostic factor in patients with ESCC. We conclude that COCC was superior to CRP or CEA as a more precise prognostic factor in patients with ESCC.

No MeSH data available.


Related in: MedlinePlus