Serum carcinoembryonic antigen levels and proliferating cell nuclear antigen labeling index for patients with colorectal carcinoma: Correlation with tumor progression and survival

BACKGROUND Clinicopathologic variables, carcinoembryonic antigen (CEA), nuclear DNA ploidy, and proliferating cell nuclear antigen labeling index (PCNA LI) have been studied for their effect on patients with various types of cancer. METHODS Thirteen clinicopathologic variables, preoperative serum CEA levels, PCNA LI, DNA ploidy patterns, and survival were studied for 57 colorectal carcinoma patients, and the mutual relation between these variables, tumor progression, and survival were analyzed. RESULTS Seven variables including undifferentiated adenocarcinoma, deep invasion, lymphatic and venous invasion, node metastasis, liver metastasis, and advanced stages were significantly greater for patients with positive CEA (> 5.0 ng/mL) than for patients with negative CEA (< 5.0 ng/mL). Three variables including deep invasion, liver metastasis, and advanced stages were significantly greater for patients with high PCNA LI (> 49.4%) than for patients with low PCNA LI (< 49.4%). No significant difference was observed in any of the variables for patients with DNA diploid or aneuploid cancer. A close relationship representing a formula, Y (log CEA, ng/mL) = 0.026X (PCNA LI, %) − 0.478, was found between CEA level and PCNA LI. Survival curves for patients with negative CEA and low PCNA LI were significantly greater than those for patients with positive CEA and high PCNA LI. Survival curves were significantly greater for patients with positive CEA and low PCNA LI than for patients with positive CEA and high PCNA LI. However, no significant difference was observed in the survival curves of patients with different DNA ploidy patterns. CONCLUSIONS Serum CEA and PCNA LI for cancer patients is useful in the evaluation of tumor progression and in prognosis. Analysis of DNA ploidy appears to be unavailable for this evaluation. Cancer 1996;77:1741‐6.