Association between Lymphovascular Invasion and Carcinoembryonic Antigen as a Prognostic Factor in Post Colorectal Cancer Surgery Patients: Literature Review

Yossi Andila; Muhammad Al Anas

doi:10.30596/jih.v7i1.26708

Association between Lymphovascular Invasion and Carcinoembryonic Antigen as a Prognostic Factor in Post Colorectal Cancer Surgery Patients: Literature Review

Yossi Andila, Muhammad Al Anas

Abstract

Background: Several prognostic factors have been proposed to reflect the course of the disease, such as demographic, histopathological, immunological, molecular and multidisciplinary interventions. Histological examination is widely used to predict prognosis and optimize adjuvant treatment, such as LVI and CEA.

Purpose and objectives: This study is a literature review that aims to see the correlation of LVI and CEA as a postoperative porgnostic indicator which is a development from previous studies regarding CEA levels on chemotherapy response

Methods: This study was a literature review focusing on the association between lymphovascular invasion and carcinoembryonic antigen as prognostic factors in post-colorectal cancer surgery patients. Two authors independently conducted searches of the PubMed, ScienceDirect, and British Medical Journal databases to identify relevant studies. Selected articles were reviewed and analyzed to synthesize current evidence on the topic.

Results: CEA normalized in more than 70% of patients after surgery, and the outcomes of patients with postoperative CEA who returned to normal were similar to those with normal preoperative CEA. Lymphovascular invasion is an independent poor prognostic marker for survival in colorectal cancer. Node negative patients, particularly stage II, are the most important group that could benefit from identification of LVI.

Conclusion: Serum CEA and LVI levels have the potential to be better biomarkers for the prognosis of colorectal cancer patients.

Keywords

Lymphovascular invasion; carcinoembryonic antigen; prognosis; colorectal cancer

Full Text:

PDF

References

Fuchs TL, Sioson L, Sheen A, Jafari-Nejad K, Renaud CJ, Andrici J, et al. Assessment of Tumor-infiltrating Lymphocytes Using International TILs Working Group (ITWG) System Is a Strong Predictor of Overall Survival in Colorectal Carcinoma: A Study of 1034 Patients. Am J Surg Pathol. 2020;44(4):536–44. https://doi.org/10.1097/PAS.0000000000001409

Li Y, Liang L, Dai W, Cai G, Xu Y, Li X, et al. Prognostic impact of programmed cell death-1 (PD-1) and PD-ligand 1 (PD-L1) expression in cancer cells and tumor infiltrating lymphocytes in colorectal cancer. Mol Cancer. 2016;15(1):55. https://doi.org/10.1186/s12943-016-0539-x

Zhong JW, Yang SX, Chen RP, Zhou YH, Ye MS, Miao L, et al. Prognostic Value of Lymphovascular Invasion in Patients with Stage III Colorectal Cancer: A Retrospective Study. Med Sci Monit. 2019;25:6043–50. https://doi.org/10.12659/MSM.918133

Huang CS, Chen CY, Huang LK, Wang WS, Yang SH. Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke. PLoS ONE. 2020;15(6):e0233687. https://doi.org/10.1371/journal.pone.0233687

van Wyk HC, Roxburgh CS, Horgan PG, Foulis AF, McMillan DC. The detection and role of lymphatic and blood vessel invasion in predicting survival in patients with node negative operable primary colorectal cancer. Crit Rev Oncol Hematol. 2014;90(1):77–90. https://doi.org/10.1016/j.critrevonc.2013.11.004

Wei X, Qiu M, Zhou Y, He M, Luo H, Wang F, et al. The clinicopathologic relevance and prognostic value of tumor deposits and the applicability of the N1c category in rectal cancer with preoperative radiotherapy. Oncotarget. 2016;7(46):75094–103. https://doi.org/10.18632/oncotarget.12058

Saito G, Sadahiro S, Kamata H, Miyakita H, Okada K, Tanaka A, et al. Monitoring of Serum Carcinoembryonic Antigen Levels after Curative Resection of Colon Cancer: Cutoff Values Determined according to Preoperative Levels Enhance the Diagnostic Accuracy for Recurrence. Oncology. 2017;92(5):276–82. https://doi.org/10.1159/000456075

Becerra AZ, Probst CP, Tejani MA, Aquina CT, González MG, Hensley BJ, et al. Evaluating the Prognostic Role of Elevated Preoperative Carcinoembryonic Antigen Levels in Colon Cancer Patients: Results from the National Cancer Database. Ann Surg Oncol. 2016;23(5):1554–61. https://doi.org/10.1245/s10434-015-5014-1

Kekelidze M. Colorectal cancer: Current imaging methods and future perspectives for the diagnosis, staging and therapeutic response evaluation. World J Gastroenterol. 2013;19(46):8502. https://doi.org/10.3748/wjg.v19.i46.8502

Konishi T, Shimada Y, Hsu M, Tufts L, Jimenez-Rodriguez R, Cercek A, et al. Association of Preoperative and Postoperative Serum Carcinoembryonic Antigen and Colon Cancer Outcome. JAMA Oncol. 2018;4(3):309. https://doi.org/10.1001/jamaoncol.2017.4420

Kim S, Huh JW, Lee WY, Yun SH, Kim HC, Cho YB, et al. Lymphovascular invasion, perineural invasion, and tumor budding are prognostic factors for stage I colon cancer recurrence. Int J Colorectal Dis. 2020;35(5):881–5. https://doi.org/10.1007/s00384-020-03548-4

Wu S, Gu W. Association of T Stage and Serum CEA Levels in Determining Survival of Rectal Cancer. Front Med. 2020;6:270. https://doi.org/10.3389/fmed.2019.00270

Abe S, Kawai K, Ishihara S, Nozawa H, Hata K, Kiyomatsu T, et al. Prognostic impact of carcinoembryonic antigen and carbohydrate antigen 19-9 in stage IV colorectal cancer patients after R0 resection. J Surg Res. 2016;205(2):384–92. https://doi.org/10.1016/j.jss.2016.06.078

Johncilla M, Yantiss RK. Histology of Colorectal Carcinoma. Surg Pathol Clin. 2020;13(3):503–20. https://doi.org/10.1016/j.path.2020.05.008

Al-Sukhni E, Attwood K, Gabriel EM, LeVea CM, Kanehira K, Nurkin SJ. Lymphovascular and perineural invasion are associated with poor prognostic features and outcomes in colorectal cancer: A retrospective cohort study. Int J Surg. 2017;37:42–9. https://doi.org/10.1016/j.ijsu.2016.08.528

Cai Z, Xiao J, He X, Ke J, Zou Y, Chen Y, et al. Accessing new prognostic significance of preoperative carcinoembryonic antigen in colorectal cancer receiving tumor resection: More than positive and negative. Cancer Biomark. 2017;19(2):161–8. https://doi.org/10.3233/CBM-160287

Ferris RL, Gallon J. Additional Support for the Introduction of Immune Cell Quantification in Colorectal Cancer Classification. J Natl Cancer Inst. 2016;108(8):djw033. https://doi.org/10.1093/jnci/djw033

Chan DLH, Segelov E, Wong RS, Smith A, Herbertson RA, Li BT, et al. Epidermal growth factor receptor (EGFR) inhibitors for metastatic colorectal cancer. Cochrane Database Syst Rev. 2017;CD007047. https://doi.org/10.1002/14651858.CD007047.pub2

Tube FK, Brown LS, Fung TT. Dietary Patterns and Colorectal Cancer Risk: A Review of 17 Years of Evidence (2000-2016). Curr Colorectal Cancer Rep. 2017;13(6):440–54. https://doi.org/10.1007/s11888-017-0390-5

Liu Q, Lian P, Luo D, Cai S, Li Q, Li X. Combination of carcinoembryonic antigen with the American Joint Committee on Cancer TNM staging system in rectal cancer: A real-world and large population-based study. OncoTargets Ther. 2018;11:5827–34. https://doi.org/10.2147/OTT.S171433

Lee N, Zakka LR, Mihm MC, Schatton T. Tumor-infiltrating lymphocytes in melanoma prognosis and cancer immunotherapy. Pathology. 2016;48(2):177–87. https://doi.org/10.1016/j.pathol.2015.12.006

Marks KM, West NP, Morris E, Quirke P. Clinicopathological, genomic and immunological factors in colorectal cancer prognosis. Br J Surg. 2018;105(2):e99–e109. https://doi.org/10.1002/bjs.10756

Jakubowska K, Koda M, Kisielewski W, Kańczuga‑Koda L, Famulski W. Tumor‑infiltrating lymphocytes in primary tumors of colorectal cancer and their metastases. Exp Ther Med. 2019. https://doi.org/10.3892/etm.2019.8146

Idos GE, Kwok J, Bonthala N, Kysh L, Gruber SB, Qu C. The Prognostic Implications of Tumor Infiltrating Lymphocytes in Colorectal Cancer: A Systematic Review and Meta-Analysis. Sci Rep. 2020;10(1):3360. https://doi.org/10.1038/s41598-020-60255-4

Chan L, Sadahiro S, Suzuki T, Okada K, Miyakita H, Yamamoto S, et al. Tissue-Infiltrating Lymphocytes as a Predictive Factor for Recurrence in Patients with Curatively Resected Colon Cancer: A Propensity Score Matching Analysis. Oncology. 2020;98(10):680–8. https://doi.org/10.1159/000506706

Kwak Y, Koh J, Kim DW, Kang SB, Kim WH, Lee HS. Immunoscore encompassing CD3+ and CD8+ T cell densities in distant metastasis is a robust prognostic marker for advanced colorectal cancer. Oncotarget. 2016;7(49):81778–90. https://doi.org/10.18632/oncotarget.13207

Lim SB, Yu CS, Jang SJ, Kim TW, Kim JH, Kim JC. Prognostic significance of lymphovascular invasion in sporadic colorectal cancer. Dis Colon Rectum. 2010;53(4):377–84. https://doi.org/10.1007/DCR.0b013e3181cf8ae5

Lee JH, Kim MG, Jung MS, Kwon SJ. Prognostic significance of lymphovascular invasion in node-negative gastric cancer. World J Surg. 2015;39(3):732–9. https://doi.org/10.1007/s00268-014-2846-y

Jiang HH, Zhang ZY, Wang XY, Tang X, Liu HL, Wang AL, et al. Prognostic significance of lymphovascular invasion in colorectal cancer and its association with genomic alterations. World J Gastroenterol. 2019;25(20):2489–502. https://doi.org/10.3748/wjg.v25.i20.2489

Silverman PM. Oncologic imaging: A multidisciplinary approach. 2022. https://www.clinicalkey.com/dura/browse/bookChapter/3-s2.0-C20180026614

Youssef MMS, Paish EC, Murray JC, Farag NM, Saleh K, Ellis IO. Tumor Infiltrating T Lymphocytes and Apoptosis in Colorectal Cancer. Egypt J Immunol. 2015;22(1):19–28.

Marks KM, West NP, Morris E, Quirke P. Clinicopathological, genomic and immunological factors in colorectal cancer prognosis. Br J Surg. 2018;105(2):e99–e109. https://doi.org/10.1002/bjs.10756

Sideris M, Papagrigoriadis S. Molecular biomarkers and classification models in the evaluation of the prognosis of colorectal cancer. Anticancer Res. 2014;34(5):2061–8.

DOI: https://doi.org/10.30596/jih.v7i1.26708

Refbacks

There are currently no refbacks.

Fakultas Kedokteran

Universitas Muhammadiyah Sumatera Utara
Jln.Gedung Arca No. 53 Medan 20217
Telp/HP/Whatsapp: +62 8112570085, +62 857-6248-0974
Website : http://jurnal.umsu.ac.id/index.php/JIH/index
Email : implementahusada@umsu.ac.id