Novel tumor marker index combining carcinoembryonic antigen and carbohydrate antigen 19-9: New prognostic factor for metastatic colorectal cancer

doi:10.4251/wjgo.v17.i5.104341

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World Journal of Gastrointestinal Oncology

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World J Gastrointest Oncol. May 15, 2025; 17(5): 104341
Published online May 15, 2025. doi: 10.4251/wjgo.v17.i5.104341

Table 1 Baseline demographic and clinical characteristics of patients according to tumor marker index groups, n (%)

	Total (n = 305)	TMI-low (n = 151)	TMI-high (n = 154)	P value
Age, mean ± SD	64.5 ± 12.4	64.1 ± 12.8	64.9 ± 12.0	0.56^a
≤ 65 years	150 (49.2)	76 (50.3)	74 (48.1)	0.69^b
> 65 years	155 (50.8)	75 (49.7)	80 (51.9)	0.69^b
Sex
Female	113 (37.0)	58 (38.4)	55 (35.7)	0.63^b
Male	192 (63.0)	93 (61.6)	99 (64.3)	0.63^b
ECOG-PS
0	108 (35.4)	54 (35.8)	54 (35.1)	0.18^c
1	156 (51.1)	83 (55)	73 (47.4)
2	36 (11.8)	12 (7.9)	24 (15.6)
3	5 (1.6)	2 (1.3)	3 (1.9)
BMI
≤ 25 kg/m²	201 (65.9)	109 (72.2)	92 (59.7)	0.02^b
> 25 kg/m²	104 (34.1)	42 (27.8)	62 (40.3)	0.02^b
Smoking history
No	172 (56.4)	81 (53.6)	91 (59.1)	0.34^b
Yes	133 (43.6)	70 (46.4)	63 (40.9)	0.34^b
Alcohol using
No	280 (91.8)	138 (91.4)	142 (92.2)	0.79^b
Yes	25 (8.2)	13 (8.6)	12 (7.8)	0.79^b
DM
No	244 (80.0)	123 (81.5)	121 (78.6)	0.53^b
Yes	61 (20.0)	28 (18.5)	33 (21.4)	0.53^b
HT
No	199 (65.2)	102 (67.5)	97 (63)	0.40^b
Yes	106 (34.8)	49 (32.5)	57 (37)	0.40^b
CAD
No	265 (86.9)	132 (87.4)	133 (86.4)	0.78^b
Yes	40 (13.1)	19 (12.6)	21 (13.6)	0.78^b
Disease status
De-novo metastatic	209 (68.5)	96 (63.6)	113 (73.4)	0.06^b
Recurrent metastatic	96 (31.5)	55 (36.4)	41 (26.6)	0.06^b
History of adjuvant CT
No	206 (67.5)	94 (62.3)	112 (72.7)	0.05^b
Yes	99 (32.5)	57 (37.7)	42 (27.3)	0.05^b
Liver metastasis
No	92 (31.2)	56 (37.1)	36 (23.4)	0.01^b
Yes	213 (69.8)	95 (62.9)	118 (76.6)	0.01^b
Lung metastasis
No	201 (65.9)	104 (68.9)	97 (63)	0.28^b
Yes	104 (34.1)	47 (31.1)	57 (37)	0.28^b
Bone metastasis
No	281 (92.1)	142 (94)	139 (90.3)	0.22^b
Yes	24 (7.9)	9 (6)	15 (9.7)	0.22^b
Peritoneal metastasis
No	233 (76.4)	106 (70.2)	127 (82.5)	0.01^b
Yes	72 (23.6)	45 (29.8)	27 (17.5)	0.01^b
Number of metastatic site
1	157 (51.5)	80 (53)	77 (50)	0.35^b
2	91 (29.8)	48 (31.8)	43 (27.9)
3	38 (12.5)	17 (11.3)	21 (13.6)
4 or more	19 (6.2)	6 (4)	13 (8.4)
Isolated liver metastasis
No	207 (67.9)	106 (70.2)	101 (65.6)	0.39^b
Yes	98 (32.1)	45 (29.8)	53 (34.4)	0.39^b
History of metastasectomy
No	242 (79.3)	110 (72.8)	132 (85.7)	0.006^b
Yes	63 (20.7)	41 (27.2)	22 (14.3)	0.006^b
Tumor location
Right side colon cancer	65 (21.3)	27 (17.9)	38 (24.7)	0.29^b
Left side colon cancer	140 (45.9)	70 (46.4)	70 (45.5)
Rectum cancer	100 (32.8)	54 (35.8)	46 (29.9)
KRAS
Wild	182 (59.7)	98 (64.9)	84 (54.5)	0.02^b
Mutant	93 (30.5)	35 (23.2)	58 (37.7)
Unknown	30 (9.8)	18 (11.9)	12 (7.8)
NRAS
Wild	236 (77.4)	114 (75.5)	122 (79.2)	0.26^b
Mutant	20 (6.6)	8 (5.3)	12 (7.8)
Unknown	49 (16.1)	29 (19.2)	20 (13)
BRAF
Wild	241 (79.0)	118 (78.1)	123 (79.9)	0.79^b
Mutant	10 (3.3)	6 (4)	4 (2.6)
Unknown	54 (17.7)	27 (17.9)	27 (17.5)
MSI status
Microsatellite stable	183 (60.0)	85 (56.3)	98 (63.6)	0.42^b
MSI-high	11 (3.6)	6 (4)	5 (3.2)
Unknown	111 (36.4)	60 (39.7)	51 (33.1)
Metastatic line(s) of CT
1	120 (40.0)	61 (40.9)	59 (39.1)	0.66^b
2	87 (29.0)	46 (30.9)	41 (27.2)
3	41 (13.7)	17 (11.4)	24 (15.9)
4 and more	52 (17.3)	25 (16.8)	27 (17.9)
Using immunotherapy
No	302 (99.0)	150 (99.3)	152 (98.7)	0.99^c
Yes	3 (1.0)	1 (0.7)	2 (1.3)	0.99^c
GPS
0	134 (43.9)	78 (51.7)	56 (36.4)	0.03^b
1	132 (43.3)	57 (37.7)	75 (48.7)
2	39 (12.8)	16 (10.6)	23 (14.9)
NLR, mean ± SD	3.45 ± 2.55	3.15 ± 1.98	3.76 ± 2.98	0.04^c

^aIndependent t test, P < 0.05 statistically significant.

^bPearson χ² test, P < 0.05 statistically significant.

^cFisher’s exact test, P < 0.05 statistically significant.

TMI: Tumor marker index; ECOG-PS: Eastern Cooperative Oncology Group Performance Status; BMI: Body mass index; DM: Diabetes mellitus; HT: Hypertension; CAD: Coronary artery disease; CT: Chemotherapy; MSI: Microsatellite instability; GPS: Glasgow prognostic score; NLR: Neutrophil-to-lymphocyte ratio.

Citation: Ilhan Y, Balcik OY, Guzel HG, Onder AH, Demir B, Baser MN, Karadag I, Ozbay MF, Genc TB, Uzuntas S, Poyrazoglu O, Beypinar I, Ergun Y, Ozturk B. Novel tumor marker index combining carcinoembryonic antigen and carbohydrate antigen 19-9: New prognostic factor for metastatic colorectal cancer. World J Gastrointest Oncol 2025; 17(5): 104341
URL: https://www.wjgnet.com/1948-5204/full/v17/i5/104341.htm
DOI: https://dx.doi.org/10.4251/wjgo.v17.i5.104341