Author/Editor		Kos, Janko; Nielsen, Hans-Jorgen; Krašovec, Marta; Christensen, Ib Jarle; Cimerman, Nina; Stephens, Ross W; Bruenner, Nils
Title		Prognostic values of cathepsin B and carcinoembryonic antigen in sera of patients with colorectal cancer
Type		članek
Source		Clin Cancer Res
Vol. and No.		Letnik 4
Publication year		1998
Volume		str. 1511-6
Language		eng
Abstract		The level of cathepsin B (Cat B) was determined in sera obtained preoperatively from 325 patients with colorectal cancer using an ELISA. Control sera from 90 healthy blood donors were analyzed. The levels of Cat B detected included all forms that were present in the sera, i.e., mature enzyme, precursor molecule, and enzyme-inhibitor complexes. The level of Cat B was significantly increased in sera of patients with colorectal cancer. The median level was 10.7 ng/ml versus 2.1 ng/ml in controls (P < 0.0001). A correlation between Cat B serum level and advanced Dukes' stage (P < 0.003) was found, whereas no associations have been found with age, sex, or level of carcinoembryonic antigen (CEA). In survival analysis, the patients with high serum Cat B experienced significantly lower survival probability. At the optimal cutoff value of 9.4 ng/ml, the relative hazard ratio was 1.8 (95% confidence interval,1.1-2.8; P = 0.016) in the univariate Cox proportional hazards model. The median observation time was 4.4 years (range, 3.2-5.5 years). In multivariate analysis, Dukes' stage was the strongest prognostic variable, followed by age, whereas serum Cat B and CEA were not significant prognostic factors in this model, in accordance with their association with Dukes' stage. When the data for Cat B and CEA were combined, CEA- positive patients were further separated by Cat B into high- and low-risk groups. Patients with high serum levels of both molecules had significantly shorter survival (relative hazard ratio of 2.2, 95% confidence interval, 1.5 - 3.2, P< 0.0001), as compared with patients with low levels of both molecules.
Descriptors		COLORECTAL NEOPLASMS CATHEPSIN B CARCINOEMBRYONIC ANTIGEN TUMOR MARKERS, BIOLOGICAL NEOPLASM STAGING PREDICTIVE VALUE OF TESTS PROGNOSIS FOLLOW-UP STUDIES MULTIVARIATE ANALYSIS PROPORTIONAL HAZARDS MODELS RISK FACTORS SURVIVAL RATE TIME FACTORS