Predictive performance of TPA testing for recurrent disease during follow-up after curative intent surgery for colorectal carcinoma

Frederik J. van der Sluis; Zhuozhao Zhan; Charlotte J. Verberne; Anneke C. Muller Kobold; Theo Wiggers; Geertruida H. de Bock

doi:10.1515/cclm-2016-0207

Article

Predictive performance of TPA testing for recurrent disease during follow-up after curative intent surgery for colorectal carcinoma

Frederik J. van der Sluis , Zhuozhao Zhan , Charlotte J. Verberne , Anneke C. Muller Kobold , Theo Wiggers and Geertruida H. de Bock

Published/Copyright: August 13, 2016

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 55 Issue 2

Abstract

Background:

The aim of the present study was to investigate the predictive performance of serial tissue polypeptide antigen (TPA) testing after curative intent resection for detection of recurrence of colorectal malignancy.

Methods:

Serum samples were obtained in 572 patients from three different hospitals during follow-up after surgery. Test characteristics of serial TPA testing were assessed using a cut-off value of 75 U/L. The relation with American Joint Committee on Cancer stage and the potential additive value of tissue polypeptide antigen testing upon standard carcinoembryonic antigen (CEA) testing were investigated.

Results:

The area under the receiver operating characteristic curve of TPA for recurrent disease was 0.70, indicating marginal usefulness as a predictive test. Forty percent of cases that were detected by CEA testing would have been missed by TPA testing alone, whilst most cases missed by CEA were also not detected by TPA testing. In the subpopulation of patients with stage III disease predictive performance was good (area under the curve 0.92 within 30 days of diagnosing recurrent disease). In this group of patients, 86% of cases that were detected by CEA were also detected by TPA.

Conclusions:

Overall, TPA is a relatively poor predictor for recurrent disease during follow-up. When looking at the specific subpopulation of patients with stage III disease predictive performance of TPA was good. However, TPA testing was not found to be superior to CEA testing in this specific subpopulation.

Keywords: carcinoembryonic antigen; colorectal cancer; local neoplasm recurrence; metastasis; tissue polypeptide antigen; tumor markers

Corresponding author: Frederik J. van der Sluis, MD, Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands, Tel.: +31 50 361 85 00

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Statistical analysis was carried out by Z.Z.
Research funding: For this study, a research grant was received from the Dutch Society for Clinical Chemistry and Laboratory Medicine. The encompassing study “CEAwatch” was sponsored by ZonMw, The Netherlands Organization for Health Research and Development.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-3-13

Accepted: 2016-7-14

Published Online: 2016-8-13

Published in Print: 2017-2-1

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Articles in the same Issue

https://doi.org/10.1515/cclm-2016-0207

Keywords for this article

carcinoembryonic antigen; colorectal cancer; local neoplasm recurrence; metastasis; tissue polypeptide antigen; tumor markers