Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 21, 2022; 10(3): 899-918
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.899
Dynamic monitoring of carcinoembryonic antigen, CA19-9 and inflammation-based indices in patients with advanced colorectal cancer undergoing chemotherapy
Nebojsa Manojlovic, Goran Savic, Bojan Nikolic, Nemanja Rancic
Nebojsa Manojlovic, Clinic for Gastroenterology and Hepatology, Military Medical Academy, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade 11000, Serbia
Goran Savic, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia, Military Medical Academy, Belgrade 11000, Serbia
Bojan Nikolic, Institute for Radiology, Military Medical Academy, Belgrade 11000, Serbia
Nemanja Rancic, Center for Clinical Pharmacology, Institute for Radiology, Military Medical Academy, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade 11000, Serbia
Author contributions: Manojlovic N was the guarantor and designed the study, participated in the acquisition, analysis and interpretation of the data, and drafted the initial manuscript; Savic G and Rancic N participated in the analysis, acquisition, interpretation of the data, and drafted the initial manuscript; Nikolic B participated in the acquisition, analysis, and interpretation of the data.
Institutional review board statement: The study protocol was reviewed and approved by the Ethics Committee of Military Medical Academy (approval number: No 8/2021), and the study was conducted in accordance with the Helsinki Declaration as revised in 2013.
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [nebojsa.manojlovic1@gmail.com]. Participants gave informed consent for data sharing.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nebojsa Manojlovic, PhD, Associate Professor, Clinic for Gastroenterology and Hepatology, Military Medical Academy, Faculty of Medicine of the Military Medical Academy, University of Defence, Crnotravska 17, Belgrade 11000, Serbia. nebojsa.manojlovic1@gmail.com
Received: July 19, 2021
Peer-review started: July 19, 2021
First decision: October 3, 2021
Revised: October 21, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: January 21, 2022
Core Tip

Core Tip: A carcinoembryonic antigen increase of 24.5% discriminates progressive disease (PD) from disease control with 80.3% sensitivity (Se) and 84% specificity (Sp) and good clinical utility index negative [CUI (Ve-)] and fraction correct (FC) values, while a reduction of -60% exclude PD with 100% Se and 37.5% Sp allowing for a 25.49% reduction in control CT examinations of unresectable metastatic colorectal cancer patients. The carbohydrate antigen level cut-off for PD was 21.49% with 66.5% Se, 87.4% Sp and acceptable CUI (Ve-) and FC values. A neutrophile-to-lymphocyte ratio increase by 11.5%, a platelet-to-lymphocyte ratio increase by 5.9%, a systemic inflammatory-immune index increase above -6.04% had acceptable CUI (Ve-) values.