Carcinoembryonic Antigen Messenger RNA in Pelvic Lavage Fluid Predicts Local Recurrence After Curative‐Intent Resection of Rectal Cancer
- 1Department of Gastroenterological Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Aichi Japan
- 2Department of Gastroenterological Surgery Nagoya City University Hospital East Medical Center Nagoya Aichi Japan
- 3Department of Gastroenterological Surgery Nagoya City University Hospital West Medical Center Nagoya Aichi Japan
Abstract
Purpose: To evaluate whether pelvic lavage carcinoembryonic antigen (CEA) mRNA is associated with local recurrence after curative‐intent resection for rectal cancer and whether it provides additional prognostic information beyond circumferential resection margin (CRM) status.
Methods: We retrospectively analyzed 178 patients who underwent curative‐intent resection for primary rectal cancer. Pelvic lavage fluid was collected intraoperatively before enterotomy, and CEA mRNA levels were quantified using quantitative reverse‐transcription polymerase chain reaction (qRT‐PCR). CEA mRNA positivity was defined as ≥ 0.26, and CRM positivity as ≤ 1 mm. Local recurrence was evaluated using Kaplan–Meier analysis and Cox proportional hazards modeling.
Results: During a median follow‐up of 59.1 months, local recurrence occurred in 8 patients (4.5%). CEA mRNA was positive in 7 patients (3.9%), and CRM was positive in 11 patients (6.2%). Local recurrence rates were 36.4% (4/11) in CRM‐positive patients and 42.9% (3/7) in CEA mRNA–positive patients. All patients who tested positive for both markers (3/3) developed local recurrence, whereas the rate was only 2.5% (4/163) among those who tested negative for both markers. In multivariable analysis, CRM positivity (HR 11.09, 95% CI 2.06–59.68, p = 0.005) and CEA mRNA positivity (HR 5.99, 95% CI 1.06–33.81, p = 0.043) remained associated with local recurrence.
Conclusions: Pelvic lavage CEA mRNA levels were associated with local recurrence beyond CRM status and may improve risk stratification. Further validation in larger multicenter cohorts is warranted.
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BibTeX
@article{asai2026carcinoembryonic,
title = {{Carcinoembryonic Antigen Messenger RNA in Pelvic Lavage Fluid Predicts Local Recurrence After Curative‐Intent Resection of Rectal Cancer}},
author = {Hiroyuki Asai and Yushi Yamakawa and Kazuyoshi Shiga and Shuhei Uehara and Akira Kato and Takuya Suzuki and Hajime Ushigome and Hiroki Takahashi and Yoichi Matsuo and Shuji Takiguchi},
journal = {Annals of Gastroenterological Surgery},
year = {2026},
month = jul,
doi = {10.1002/ags3.70257},
url = {https://doi.org/10.1002/ags3.70257},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Carcinoembryonic Antigen Messenger RNA in Pelvic Lavage Fluid Predicts Local Recurrence After Curative‐Intent Resection of Rectal Cancer
AU - Hiroyuki Asai
AU - Yushi Yamakawa
AU - Kazuyoshi Shiga
AU - Shuhei Uehara
AU - Akira Kato
AU - Takuya Suzuki
AU - Hajime Ushigome
AU - Hiroki Takahashi
AU - Yoichi Matsuo
AU - Shuji Takiguchi
PY - 2026
DA - 2026/07/31
JO - Annals of Gastroenterological Surgery
DO - 10.1002/ags3.70257
UR - https://doi.org/10.1002/ags3.70257
AB - Purpose: To evaluate whether pelvic lavage carcinoembryonic antigen (CEA) mRNA is associated with local recurrence after curative‐intent resection for rectal cancer and whether it provides additional prognostic information beyond circumferential resection margin (CRM) status. Methods: We retrospectively analyzed 178 patients who underwent curative‐intent resection for primary rectal cancer. Pelvic lavage fluid was collected intraoperatively before enterotomy, and CEA mRNA levels were quantified using quantitative reverse‐transcription polymerase chain reaction (qRT‐PCR). CEA mRNA positivity was defined as ≥ 0.26, and CRM positivity as ≤ 1 mm. Local recurrence was evaluated using Kaplan–Meier analysis and Cox proportional hazards modeling. Results: During a median follow‐up of 59.1 months, local recurrence occurred in 8 patients (4.5%). CEA mRNA was positive in 7 patients (3.9%), and CRM was positive in 11 patients (6.2%). Local recurrence rates were 36.4% (4/11) in CRM‐positive patients and 42.9% (3/7) in CEA mRNA–positive patients. All patients who tested positive for both markers (3/3) developed local recurrence, whereas the rate was only 2.5% (4/163) among those who tested negative for both markers. In multivariable analysis, CRM positivity (HR 11.09, 95% CI 2.06–59.68, p = 0.005) and CEA mRNA positivity (HR 5.99, 95% CI 1.06–33.81, p = 0.043) remained associated with local recurrence. Conclusions: Pelvic lavage CEA mRNA levels were associated with local recurrence beyond CRM status and may improve risk stratification. Further validation in larger multicenter cohorts is warranted.
SN - 2475-0328
ER -