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Published on: March 14, 2019
Association between the preoperative Midkine (+)/CEA (+) level and poor prognosis in colorectal cancer patients
Mitsunori Ushigome1, Hideaki Shimada2, Masaaki Ito1
1Department of Surgery, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Purpose:
To evaluate the clinicopathological and prognostic significance of preoperative serum Midkine levels in patients with colorectal cancer.
Methods:
Preoperative Midkine levels were analyzed using an enzyme-linked immunosorbent assay in 78 patients with colorectal cancer, at stages 0 (n = 2), I (n = 19), II (n = 25), III (n = 24), and IV (n = 8). Using a cut-off value of 421 pg/mL, the patients were divided into a Midkine(+) group and a Midkine(-) group. Clinicopathological factors and prognosis were compared between the two groups, using univariate and multivariate analyses.
Results:
The overall positive rates were 46%, 32%, and 21% for CEA, Midkine, and CA19-9, respectively. The positive rate of the Midkine/CEA combination was 55%. The positive rates at stage 0/I were 19%, 19%, and 5% for CEA, Midkine, and CA19-9, respectively. The Midkine(+) group showed poor survival, but the differences were not significant. The Midkine (+)/CEA (+) group had significantly worse relapse-free survival (RFS) (p = 0.02). The Midkine (+)/CEA (+) level was an independent risk factor for RFS (p = 0.04) and overall survival (p = 0.03).
Conclusion:
The Midkine (+)/CEA (+) combination may be an indicator of poor prognosis for patients with colorectal cancer.
