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CC BY 4.0 · Journal of Coloproctology 2025; 45(04): s00451801890
DOI: 10.1055/s-0045-1801890
Original Article

Prognostic Factor Associated with Pre- and Postneoadjuvant Carcinoembryonic Antigen in Patients with Middle and Low Rectal Adenocarcinoma and its Correlation with Pathological Findings

Authors

  • Isaac José Felippe Corrêa Neto 

    1   Department of Semiology, Medical Propedeutics, and General Surgery, Faculdade Santa Marcelina, São Paulo, SP, Brazil
    2   Coloproctology Service, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil

  • Matheus Iguera Cirqueira

    3   Faculdade Santa Marcelina, São Paulo, SP, Brazil

  • Gabriel Fiorot Cruz Sperandio

    2   Coloproctology Service, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil

  • Gabriela Portal Monteiro

    2   Coloproctology Service, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil

  • Yasmin Gois de Mello

    2   Coloproctology Service, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil

  • Victor Keniti Gomes Nishiyama

    4   Departament of Urology, Hospital Edmundo Vasconcelos, São Paulo, SP, Brazil

  • Rodrigo Ambar Pinto

    5   Department of Surgery of the Digestive System and Coloproctology, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil

  • Laercio Robles

    2   Coloproctology Service, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil

Funding The author(s) received no financial support for the research.
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Abstract

Introduction

Colorectal cancer (CRC) ranks among the top three most common cancers in Brazil, and the carcinoembryonic antigen (CEA) is one of the most used and established methods for prognostic evaluation and recurrence monitoring in CRC patients.

Objective

To analyze the pre- and postneoadjuvant levels of CEA in patients with middle or low rectal adenocarcinoma who underwent elective retossigmoidectomy with total mesorectal excision or abdominoperineal amputation of the rectum and to correlate the differences in pre- and postneoadjuvant CEA levels with the pathological staging.

Materials and Methods

Retrospective analysis of patients over 18 years old who underwent elective retossigmoidectomy with total mesorectal excision or abdominoperineal resection of the rectum. Data regarding age, sex, type of surgery, absolute CEA values, and differences in pre- and postneoadjuvant CEA levels were evaluated.

Results

The electronic medical records of 77 patients diagnosed with middle or low rectal adenocarcinoma who underwent surgery were analyzed. The mean pre- and postneoadjuvant levels of CEA were of 15.21(± 26.41) ng/mL and 7.17(± 15.6) ng/mL respectively, indicating a statistically significant decrease (p = 0.00058). The cutoff value for the analysis of neoplastic invasion depth (T) was determined to be 4.9 ng/mL, with a sensitivity of 73%, specificity of 63%, positive predictive value of 81%, and accuracy of 66.7%. For disease stage N, a cutoff value of 16.5 ng/mL was used. In this sample, the CEA test showed that the sensitivity and specificity for identifying patients with positive N disease were 41% and 89%, respectively, with a positive predictive value of 70% and an accuracy of 59.7%.

Conclusion

Carcinoembryonic antigen levels significantly decreased after neoadjuvant therapy in patients with middle and low rectal cancer. Pretreatment CEA levels were primarily associated with tumor invasion depth.

Keywords

colorectal cancer - carcinoembryonic antigen - prognostic

Authors' Contributions

Isaac José Felippe Corrêa Neto was responsible for drafting the article and conducting an analysis of the literature. Matheus Iguera Cirqueira, Gabriela Portal Monteiro, and Yasmin Gois de Mello contributed to the identification of study patients and the analysis of electronic medical records, ensuring the precision and organization of clinical data. Gabriel Fiorot Cruz Sperandio carried out the bibliographic review and the initial revision of the manuscript. Victor Keniti Gomes Nishiyama played a role in statistical analysis, ensuring methodological rigor in the results. Rodrigo Ambar Pinto collaborated on the initial revision and provided a critical analysis of the literature, strengthening the theoretical foundation of the article. Laercio Robles was responsible for the final revision and approval of the manuscript, ensuring its quality before completion.




Publication History

Received: 04 October 2024

Accepted: 29 October 2024

Article published online:
29 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Isaac José Felippe Corrêa Neto, Matheus Iguera Cirqueira, Gabriel Fiorot Cruz Sperandio, Gabriela Portal Monteiro, Yasmin Gois de Mello, Victor Keniti Gomes Nishiyama, Rodrigo Ambar Pinto, Laercio Robles. Prognostic Factor Associated with Pre- and Postneoadjuvant Carcinoembryonic Antigen in Patients with Middle and Low Rectal Adenocarcinoma and its Correlation with Pathological Findings. Journal of Coloproctology 2025; 45: s00451801890.
DOI: 10.1055/s-0045-1801890