{"title":"Prognostic value of carcinoembryonic antigen in colorectal adenocarcinoma: expanding hypotheses into clinical practice.","authors":"Adam Thomas Cristaudo, David Lewis Morris","doi":"10.1007/s10238-024-01547-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study seeks to resolve a fundamental question in oncology: Why do appendiceal and colorectal adenocarcinomas exhibit distinct liver metastasis rates? Building on our prior hypothesis published in the British Journal of Surgery, our institution has investigated potential DNA mutations within the carcinoembryonic antigen-related cell adhesion molecule (CEACAM5) gene's Pro-Glu-Leu-Pro-Lys (PELPK) motif to evaluate its role as a biomarker for liver metastasis risk.</p><p><strong>Methods: </strong>Partnering with the Australian Genome Research Facility, the PELPK motif of CEACAM5 was analysed in colorectal and appendiceal adenocarcinomas to detect DNA mutations associated with liver metastasis. Additionally, our institution performed the COPPER trial to assess carcinoembryonic antigen (CEA) levels in portal versus peripheral blood in patients with appendiceal adenocarcinoma and a systematic review and meta-analysis of 136 studies on CEA's prognostic significance among patients with colorectal and appendiceal adenocarcinoma.</p><p><strong>Results: </strong>No mutations were identified within the PELPK region. The COPPER trial further demonstrated no statistically significant differences in CEA levels between portal and peripheral blood in appendiceal adenocarcinoma. However, the systematic review and meta-analysis confirmed CEA's prognostic role in patients with appendiceal or colorectal adenocarcinoma.</p><p><strong>Conclusion: </strong>The absence of DNA mutations suggests that metastatic potential may be driven by downstream mRNA or protein modifications in the CEA PELPK region. Future work will include surface plasmon resonance studies to investigate CEA-receptor interactions and development of immunohistochemistry for CEA PELPK expression. Such findings are poised to redefine global strategies for cancer stratification and targeted immunotherapy, setting the stage for groundbreaking advancements in cancer prognosis and patient outcomes.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"25 1","pages":"30"},"PeriodicalIF":3.2000,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698812/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10238-024-01547-1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study seeks to resolve a fundamental question in oncology: Why do appendiceal and colorectal adenocarcinomas exhibit distinct liver metastasis rates? Building on our prior hypothesis published in the British Journal of Surgery, our institution has investigated potential DNA mutations within the carcinoembryonic antigen-related cell adhesion molecule (CEACAM5) gene's Pro-Glu-Leu-Pro-Lys (PELPK) motif to evaluate its role as a biomarker for liver metastasis risk.
Methods: Partnering with the Australian Genome Research Facility, the PELPK motif of CEACAM5 was analysed in colorectal and appendiceal adenocarcinomas to detect DNA mutations associated with liver metastasis. Additionally, our institution performed the COPPER trial to assess carcinoembryonic antigen (CEA) levels in portal versus peripheral blood in patients with appendiceal adenocarcinoma and a systematic review and meta-analysis of 136 studies on CEA's prognostic significance among patients with colorectal and appendiceal adenocarcinoma.
Results: No mutations were identified within the PELPK region. The COPPER trial further demonstrated no statistically significant differences in CEA levels between portal and peripheral blood in appendiceal adenocarcinoma. However, the systematic review and meta-analysis confirmed CEA's prognostic role in patients with appendiceal or colorectal adenocarcinoma.
Conclusion: The absence of DNA mutations suggests that metastatic potential may be driven by downstream mRNA or protein modifications in the CEA PELPK region. Future work will include surface plasmon resonance studies to investigate CEA-receptor interactions and development of immunohistochemistry for CEA PELPK expression. Such findings are poised to redefine global strategies for cancer stratification and targeted immunotherapy, setting the stage for groundbreaking advancements in cancer prognosis and patient outcomes.
期刊介绍：
Clinical and Experimental Medicine (CEM) is a multidisciplinary journal that aims to be a forum of scientific excellence and information exchange in relation to the basic and clinical features of the following fields: hematology, onco-hematology, oncology, virology, immunology, and rheumatology. The journal publishes reviews and editorials, experimental and preclinical studies, translational research, prospectively designed clinical trials, and epidemiological studies. Papers containing new clinical or experimental data that are likely to contribute to changes in clinical practice or the way in which a disease is thought about will be given priority due to their immediate importance. Case reports will be accepted on an exceptional basis only, and their submission is discouraged. The major criteria for publication are clarity, scientific soundness, and advances in knowledge. In compliance with the overwhelmingly prevailing request by the international scientific community, and with respect for eco-compatibility issues, CEM is now published exclusively online.
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