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Enhanced prognostic value of combined circulating tumor cells and serum carcinoembryonic antigen in patients with colorectal cancer.

BACKGROUND: Circulating tumor cells (CTCs) have been investigated as potential biomarker for predicting prognosis and monitoring therapeutic responses in colorectal cancer. However, the sensitivity of CTCs detection is low, thus limiting clinical utility of CTCs. We aim to examine the clinicopathological parameters that improve prognosis prediction for colorectal cancer using CTCs as a biomarker.

METHODS: We enumerated CTCs in 186 CRC patients and associated the number of CTCs with the clinicopathological features and overall survival using univaritate and multivariate Cox regression model and Kaplan-Meier survival analysis.

RESULTS: The presence of CTCs from 186 CRC patients was significantly associated with stage, pre-operational CEA, and CA19-9 levels. Using Kaplan-Meier survival and Cox regression analysis, patients with 5 or more CTCs exhibited significantly worse overall survival (OS) compared to patients with fewer than 5 CTCs. The combination of CTCs with tumor marker CEA has a better overall survival prediction than individual CTCs or CEA and serve as a more effective prediction model in patients with CRC.

CONCLUSION: We identified that patients with more than 5 CTCs exhibited significantly worse overall survival. Additionally, patients with normal level of CEA, but who also had more than 5 CTCs trended towards a worse overall survival.

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