Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy
AimsThis study aims to develop a simple, clinically applicable classification system to predict pCR based on carcinoembryonic antigen (CEA) trajectory during NAC.MethodsThis study included 366 AGC patients who received NAC followed by radical gastrectomy. CEA levels were measured before, during, and...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1525324/full |
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| author | Yonghe Chen Yonghe Chen Yonghe Chen Dan Liu Kaikai Wei Yi Lin Yi Lin Yi Lin Zhong Wang Qian Sun Huashe Wang Huashe Wang Huashe Wang Junsheng Peng Junsheng Peng Junsheng Peng Lei Lian Lei Lian Lei Lian |
| author_facet | Yonghe Chen Yonghe Chen Yonghe Chen Dan Liu Kaikai Wei Yi Lin Yi Lin Yi Lin Zhong Wang Qian Sun Huashe Wang Huashe Wang Huashe Wang Junsheng Peng Junsheng Peng Junsheng Peng Lei Lian Lei Lian Lei Lian |
| author_sort | Yonghe Chen |
| collection | DOAJ |
| description | AimsThis study aims to develop a simple, clinically applicable classification system to predict pCR based on carcinoembryonic antigen (CEA) trajectory during NAC.MethodsThis study included 366 AGC patients who received NAC followed by radical gastrectomy. CEA levels were measured before, during, and after NAC, with changes classified into three trajectory types: Type I (>=80% decline), Type II (>=40% but <80% decline), and Type III (<40% decline or increase). We analyzed associations between these CEA trajectories, pCR, lymph node remission, and survival.ResultspCR was achieved in 10.4% (38/366) of patients. pCR rates were significantly higher in Type I (41%) and Type II (15.8%) trajectories compared to Type III (6.7%). Lymph node remission also correlated with CEA trajectories, with Type I having the highest proportion of ypN0 (79.2%). Multivariate analysis identified CEA trajectory subtypes and tumor differentiation as independent predictors of pCR. This classification system proved robust across subgroups. Although no significant differences in overall survival were observed between subtypes, higher initial CEA levels were associated with worse survival.ConclusionThe trajectory of CEA change during NAC is a promising predictor of pCR in AGC. This simple and accessible classification system may facilitate personalized surgical strategies for patients with AGC. |
| format | Article |
| id | doaj-art-36cefd16f6224c919af82cf536c866bf |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-36cefd16f6224c919af82cf536c866bf2025-02-10T05:16:21ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-02-011510.3389/fonc.2025.15253241525324Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapyYonghe Chen0Yonghe Chen1Yonghe Chen2Dan Liu3Kaikai Wei4Yi Lin5Yi Lin6Yi Lin7Zhong Wang8Qian Sun9Huashe Wang10Huashe Wang11Huashe Wang12Junsheng Peng13Junsheng Peng14Junsheng Peng15Lei Lian16Lei Lian17Lei Lian18Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Laboratory Science, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of General Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaSchool of Nursing, Sun Yat-sen University, Guangzhou, ChinaSchool of Nursing, Sun Yat-sen University, Guangzhou, ChinaDepartment of General Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of General Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of General Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaBiomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaAimsThis study aims to develop a simple, clinically applicable classification system to predict pCR based on carcinoembryonic antigen (CEA) trajectory during NAC.MethodsThis study included 366 AGC patients who received NAC followed by radical gastrectomy. CEA levels were measured before, during, and after NAC, with changes classified into three trajectory types: Type I (>=80% decline), Type II (>=40% but <80% decline), and Type III (<40% decline or increase). We analyzed associations between these CEA trajectories, pCR, lymph node remission, and survival.ResultspCR was achieved in 10.4% (38/366) of patients. pCR rates were significantly higher in Type I (41%) and Type II (15.8%) trajectories compared to Type III (6.7%). Lymph node remission also correlated with CEA trajectories, with Type I having the highest proportion of ypN0 (79.2%). Multivariate analysis identified CEA trajectory subtypes and tumor differentiation as independent predictors of pCR. This classification system proved robust across subgroups. Although no significant differences in overall survival were observed between subtypes, higher initial CEA levels were associated with worse survival.ConclusionThe trajectory of CEA change during NAC is a promising predictor of pCR in AGC. This simple and accessible classification system may facilitate personalized surgical strategies for patients with AGC.https://www.frontiersin.org/articles/10.3389/fonc.2025.1525324/fullgastric cancercarcinoembryonic antigentrajectory analysis (TA)pathological complete responseneoadjuvant chemotherapy |
| spellingShingle | Yonghe Chen Yonghe Chen Yonghe Chen Dan Liu Kaikai Wei Yi Lin Yi Lin Yi Lin Zhong Wang Qian Sun Huashe Wang Huashe Wang Huashe Wang Junsheng Peng Junsheng Peng Junsheng Peng Lei Lian Lei Lian Lei Lian Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy Frontiers in Oncology gastric cancer carcinoembryonic antigen trajectory analysis (TA) pathological complete response neoadjuvant chemotherapy |
| title | Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy |
| title_full | Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy |
| title_fullStr | Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy |
| title_full_unstemmed | Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy |
| title_short | Carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy |
| title_sort | carcinoembryonic antigen trajectory predicts pathological complete response in advanced gastric cancer after neoadjuvant chemotherapy |
| topic | gastric cancer carcinoembryonic antigen trajectory analysis (TA) pathological complete response neoadjuvant chemotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1525324/full |
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