Analysis of Carcinoembryonic Antigen (CEA) markers and Lymphocyte Monocyte Ratio (LMR) in patients with colorectal cancer

Wihelmina Yuliana Beatrix Madjar; Agus Alim Abdullah; Uleng Bahrun

doi:10.15562/ijbs.v17i1.445

Analysis of Carcinoembryonic Antigen (CEA) markers and Lymphocyte Monocyte Ratio (LMR) in patients with colorectal cancer

Wihelmina Yuliana Beatrix Madjar ,

Agus Alim Abdullah ,

Uleng Bahrun ,

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DOI: https://doi.org/10.15562/ijbs.v17i1.445 |
Published: 2023-07-03

Abstract

Background: Colorectal cancer (CRC) is cancer of the colon or rectum and one of the leading causes of cancer-related deaths. The marker for CRC is Carcinoembryonic Antigen (CEA). Lymphocytes play a role in cytotoxic cell death, inhibition of tumor cell proliferation, and migration. Lymphocyte Monocyte Ratio (LMR) is an easy-to-use laboratory biomarker to predict clinical outcomes in patients with colon cancer. This study aims to evaluate the relationship between CEA and LMR levels with the severity of CRC.

Methods: The researcher cross-sectional analyzed 53 CRC patients by taking secondary data from medical records of colorectal cancer patients, CEA, and CBC data at Dr. Wahidin Sudirohusodo Hospital Makassar. The data were grouped and then analyzed statistically. Data analysis was performed using SPSS version 25.0 for Windows

Results: The number of patients with male sex was 38 people (71.7%) and 15 women (28.3%). The age group of the patients ranged from 32 to 84 years, with a mean of 58.1 ± 11.3 years. The most severe degree of CRC was moderate, 29 people (73.6%), followed by mild degree, 8 people (15.1%), and severe degree, 6 people (11.3%). There is a significant negative correlation between LMR and CEA (r=-0.357; p=0.009)

Conclusion: There is a significant negative correlation between LMR and CEA. A decrease in LMR can be associated with a poor prognosis in cancer patients, whereas an increase in LMR before treatment can provide a good prognosis

References

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Weitz J, Koch M, Debus J, Höhler T, Galle PR, Büchler MW. Colorectal cancer. Lancet. 2005;365(9454):153-165.
Kahi CJ, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colonoscopy Surveillance After Colorectal Cancer Resection: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2016;150(3):758-768.e11.
Sun Z, Zhang N. Clinical evaluation of CEA, CA19-9, CA72-4 and CA125 in gastric cancer patients with neoadjuvant chemotherapy. World J Surg Oncol. 2014;12:397.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7-30.
Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends--An Update. Cancer Epidemiol Biomarkers Prev. 2016;25(1):16-27.
Sun HL, Pan YQ, He BS, Nie ZL, Lin K, Peng HX, et al. Prognostic performance of lymphocyte-to-monocyte ratio in diffuse large B-cell lymphoma: an updated meta-analysis of eleven reports. Onco Targets Ther. 2016;9:3017-23.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86.
Li Y, Jia H, Yu W, Xu Y, Li X, Li Q, et al. Nomograms for predicting prognostic value of inflammatory biomarkers in colorectal cancer patients after radical resection. Int J Cancer. 2016 Jul 1;139(1):220-31.
Labeda I, Lusikooy RE, Mappincara, Dani MI, Sampetoding S, Kusuma MI, et al. Colorectal cancer survival rates in Makassar, Eastern Indonesia: A retrospective Cohort Study. Ann Med Surg (Lond). 2021;74:103211.
Wong MC, Ding H, Wang J, Chan PS, Huang J. Prevalence and risk factors of colorectal cancer in Asia. Intest Res. 2019;17(3):317-329.
Chen Y, Han C, Huang Y, Liu C, Sheng S, Ji L, et al. The incidence of second primary cancer in male and female patients with initial colorectal cancer: a SEER population-based study. Eur J Cancer Prev. 2022;31(5):430-441.
Tan D, Fu Y, Tong W, Li F. Prognostic significance of lymphocyte to monocyte ratio in colorectal cancer: A meta-analysis. Int J Surg. 2018;55:128-138.
Hu RJ, Liu Q, Ma JY, Zhou J, Liu G. Preoperative lymphocyte-to-monocyte ratio predicts breast cancer outcome: A meta-analysis. Clin Chim Acta. 2018;484:1-6.
Huszno J, Kolosza Z. Prognostic value of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratio in breast cancer patients. Oncol Lett. 2019;18(6):6275-6283.
Subki AH, Alghamdi TA, Butt NS, Alqazlan MS, Alkahtani AM, Aziz MA, et al. CEA and CA19-9 Levels and KRAS Mutation Status as Biomarkers for Colorectal Cancer. Clin. Oncol, 2021;6:1-7.
Lakemeyer L, Sander S, Wittau M, Henne-Bruns D, Kornmann M, Lemke J. Diagnostic and Prognostic Value of CEA and CA19-9 in Colorectal Cancer. Diseases. 2021;9(1):21.
Zhou S, Sheng N, Ren J, He Q, Zhang Y, Gong J, et al. Clinical Significance of and Predictive Risk Factors for the Postoperative Elevation of Carcinoembryonic Antigen in Patients With Non-Metastatic Colorectal Cancer. Front Oncol. 2021;11:741309.
Huang L, Hu Z, Luo R, Li H, Yang Z, Qin X, et al. Predictive Values of the Selected Inflammatory Indexes in Colon Cancer. Cancer Control. 2022;29:10732748221091333.
Adnyani PY, Mahartini NN, Herawati S, Mulyantari NK, Lestari AAW. Comparison of Neutrophil to Lymphocyte Ratio (NLR) and Lymphocyte to Monocyte Ratio (LMR) values in controlled and uncontrolled Type 2 Diabetes Mellitus (T2DM) patient. Bali Medical Journal. 2021;10(2):798-801.
Wibowo AA, Sitompul A, Yasmina A, Oktaviyanti IK, Lahdimawan A, Damayanthi ED. An increase in inflammatory cells related to the increase incidence of colitis and colorectal cancer. Bali Medical Journal. 2022;11(1):499-502.
Suryaningprang AHP, Putranto AS, Nurachman LA. Prognostic scoring system to predict mortality after surgery in resectable colorectal cancer. Bali Medical Journal. 2023;12(2):1625-1632.

[1] Shibata D, Reale MA, Lavin P, Silverman M, Fearon ER, Steele G Jr, et al. The DCC protein and prognosis in colorectal cancer. N Engl J Med. 1996;335(23):1727-32.

[2] Weitz J, Koch M, Debus J, Höhler T, Galle PR, Büchler MW. Colorectal cancer. Lancet. 2005;365(9454):153-165.

[3] Kahi CJ, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colonoscopy Surveillance After Colorectal Cancer Resection: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2016;150(3):758-768.e11.

[4] Sun Z, Zhang N. Clinical evaluation of CEA, CA19-9, CA72-4 and CA125 in gastric cancer patients with neoadjuvant chemotherapy. World J Surg Oncol. 2014;12:397.

[5] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7-30.

[6] Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends--An Update. Cancer Epidemiol Biomarkers Prev. 2016;25(1):16-27.

[7] Sun HL, Pan YQ, He BS, Nie ZL, Lin K, Peng HX, et al. Prognostic performance of lymphocyte-to-monocyte ratio in diffuse large B-cell lymphoma: an updated meta-analysis of eleven reports. Onco Targets Ther. 2016;9:3017-23.

[8] Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86.

[9] Li Y, Jia H, Yu W, Xu Y, Li X, Li Q, et al. Nomograms for predicting prognostic value of inflammatory biomarkers in colorectal cancer patients after radical resection. Int J Cancer. 2016 Jul 1;139(1):220-31.

[10] Labeda I, Lusikooy RE, Mappincara, Dani MI, Sampetoding S, Kusuma MI, et al. Colorectal cancer survival rates in Makassar, Eastern Indonesia: A retrospective Cohort Study. Ann Med Surg (Lond). 2021;74:103211.

[11] Wong MC, Ding H, Wang J, Chan PS, Huang J. Prevalence and risk factors of colorectal cancer in Asia. Intest Res. 2019;17(3):317-329.

[12] Chen Y, Han C, Huang Y, Liu C, Sheng S, Ji L, et al. The incidence of second primary cancer in male and female patients with initial colorectal cancer: a SEER population-based study. Eur J Cancer Prev. 2022;31(5):430-441.

[13] Tan D, Fu Y, Tong W, Li F. Prognostic significance of lymphocyte to monocyte ratio in colorectal cancer: A meta-analysis. Int J Surg. 2018;55:128-138.

[14] Hu RJ, Liu Q, Ma JY, Zhou J, Liu G. Preoperative lymphocyte-to-monocyte ratio predicts breast cancer outcome: A meta-analysis. Clin Chim Acta. 2018;484:1-6.

[15] Huszno J, Kolosza Z. Prognostic value of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratio in breast cancer patients. Oncol Lett. 2019;18(6):6275-6283.

[16] Subki AH, Alghamdi TA, Butt NS, Alqazlan MS, Alkahtani AM, Aziz MA, et al. CEA and CA19-9 Levels and KRAS Mutation Status as Biomarkers for Colorectal Cancer. Clin. Oncol, 2021;6:1-7.

[17] Lakemeyer L, Sander S, Wittau M, Henne-Bruns D, Kornmann M, Lemke J. Diagnostic and Prognostic Value of CEA and CA19-9 in Colorectal Cancer. Diseases. 2021;9(1):21.

[18] Zhou S, Sheng N, Ren J, He Q, Zhang Y, Gong J, et al. Clinical Significance of and Predictive Risk Factors for the Postoperative Elevation of Carcinoembryonic Antigen in Patients With Non-Metastatic Colorectal Cancer. Front Oncol. 2021;11:741309.

[19] Huang L, Hu Z, Luo R, Li H, Yang Z, Qin X, et al. Predictive Values of the Selected Inflammatory Indexes in Colon Cancer. Cancer Control. 2022;29:10732748221091333.

[20] Adnyani PY, Mahartini NN, Herawati S, Mulyantari NK, Lestari AAW. Comparison of Neutrophil to Lymphocyte Ratio (NLR) and Lymphocyte to Monocyte Ratio (LMR) values in controlled and uncontrolled Type 2 Diabetes Mellitus (T2DM) patient. Bali Medical Journal. 2021;10(2):798-801.

[21] Wibowo AA, Sitompul A, Yasmina A, Oktaviyanti IK, Lahdimawan A, Damayanthi ED. An increase in inflammatory cells related to the increase incidence of colitis and colorectal cancer. Bali Medical Journal. 2022;11(1):499-502.

[22] Suryaningprang AHP, Putranto AS, Nurachman LA. Prognostic scoring system to predict mortality after surgery in resectable colorectal cancer. Bali Medical Journal. 2023;12(2):1625-1632.

Analysis of Carcinoembryonic Antigen (CEA) markers and Lymphocyte Monocyte Ratio (LMR) in patients with colorectal cancer

Abstract

References

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