Tumor-associated antigen CA72-4 expression pattern as a significant determinant of prognosis and recurrence pattern in patients with colorectal carcinoma

Purpose: The purpose of this study was to identify the clinical impact of CA72-4 stainig patterns on the prognosis and recurrence patterns in patients with colorectal carcinomas. Materials and methods: Tissue samples were collected from 211 colorectal carcinoma patients who underwent curative resection during the period from January 1996 to December 2000. The correlations between the staining patterns of CEA and CA72-4 and clinicopathological factors were analyzed and then patients outcomes were reviewed. The localization patterns of CEA staining were classified into apicoluminal (AL) and diffuse-cytoplasmic (DC) patterns in the tumor (CEAtumor) and invasive tumor margin (CEAmargin). The patterns of CA72-4 staining were classified into two groups : positive or negative staining patterns in the tumor (CA72-4 (tumor) cyto) and invasive tumor margin (CA72-4 (margin) cyto). In addition, the CA72-4 (B72.3) staining patterns in the extracellular tissue (CA72-4ex) were classified into two groups : positive or negative staining groups. Results: Patients with a positive staining pattern of CA72-4ex showed shorter overall survival than those with a negative CA72-4ex staining pattern. A multivariate analysis showed that the positive CA72-4ex staining pattern affected the overall survival with the highest Hazard rate. Patients with a positive CA72-4ex staining pattern showed a lower survival rate after recurrence than those with a negative CA72-4ex staining pattern. The difference was statistically significant (p = 0.0063). Non-hematogenous recurrence developed far more frequently in patients with a positive CA72-4 (tumor) cyto or CA72-4ex staining pattern than in those who stained negative for these patterns, respectively (p = 0.0232, p = 0.0221). Conclusions: Patients with a positive CA72-4ex staining pattern showed poorer outcomes and lower survival rate after recurrence because of a higher rate of non-hematogenous recurrence. Our study suggested that the extracellular staining patterns of CA72-4 may be useful for decision making regarding treatment after recurrence in patients with colorectal carcinoma.