CA125: A superior prognostic biomarker for colorectal cancer compared to CEA, CA19-9 or CA242

Abstract

OBJECTIVES: The tumor stage represents the single most important prognostic factor for colorectal cancer (CRC), although more accurate prognostics remain much needed. Previously, we identified CA125 as an independent significant prognostic factor, which we have further validated along with CEA, CA19-9, and CA242 in a large cohort of CRC patients. METHODS: Using enzyme-linked immunosorbent assays, we analyzed preoperative serum samples in 322 CRC patients operated on between 1998 and 2003. RESULTS: Using the Spearman’s rho model, we calculated the correlation between our previous findings on MUC16 and CA125, for which the correlation coefficient was 0.808 (p < 0.001). The Cox regression analysis of the linear and logarithmic values of CEA, CA125, CA242, and CA19-9 identified only CA125 (hazard ratio [HR] 1.03; 95% confidence interval [95% CI] 1.02−1.04; p < 0.001) as significant when using the linear values. Survival among CRC patients with a high CA125 level was poor compared with CRC patients with a low CA125 level (HR 2.48; 95% CI 1.68–3.65; p < 0.001). In subgroup analyses, patients with high CA125 levels and aged ≤67 or >67, with stage I–II or III–IV, and both colon and rectal cancer exhibited poor prognoses. In the multivariate analysis, we used clinical pathological variables in the model, where age, gender, and stage served as the background characteristics. We dichotomized CA125 using the Youden maximal cutoff point, and the median values for CEA, CA19-9, and CA242. CA125 emerged as the only marker remaining significant and independent together with stage, location, and age (HR 1.91; 95% CI 1.24–2.95; p 0.003). CONCLUSIONS: CA125 represents a significant and independent prognostic factor in CRC patients, superior to CEA. Furthermore, CA242 served as a better prognostic marker than both CEA and CA19-9. We recommend including both CA125 and CA242 in prognostic clinical trials among CRC patients.

Bioinformatics Analysis Based on TCGA: MUC16 Mutation Correlates with Clinical Outcome in Gastric Cancer

“…Comparative studies using MUC16 and other tumor markers, such as carcinoembryonic antigen, have been conducted on colorectal adenocarcinomas [ 36 ]. MUC16 has been found to have potential relevance as a future serological marker (CEA) [ 37 ]. A correlation has been shown between the upregulation of MUC16 and the progression of pancreatic ductal adenocarcinoma.…”

A Clinical Diagnostic Value Analysis of Serum CA125, CA199, and HE4 in Women with Early Ovarian Cancer: Systematic Review and Meta-Analysis

“…The expression of CA125 is associated with multiple systemic tumors (ovarian cancer, digestive system malignancy, tongue cancer, breast cancer, lung cancer, et al). A large number of studies [ 8 , 9 ] have reported that serum CA125 expression level varies in different ovarian cancer tissue types and surgical pathological stages, and the critical value of diagnosis is CA125 > 35 U/mL. A study showed that the serum CA125 in patients with ovarian epithelial cancer was significantly higher than that in germ cell tumor and sex cord-stromal tumor groups.…”

Prognostic Implication of Preoperative Serum Albumin to Carcinoembryonic Antigen Ratio in Colorectal Cancer Patients

“… 47 For CEA, Björkman K et al investigated 322 staged I to IV CRC and found that CA125 was superior to CEA in predicting disease-specific survival (DSS). 48 In recent years, some authors have tried to combine ALB or CEA with other markers to further improve their prognostic efficacy. For ALB, Matsuoka et al collected 133 stage III CRC and explored the prognostic value of pre- and postoperative CAR, which was found to be an independent prognostic factor for recurrence-free survival and OS, but its AUC was only 0.63 and was the highest of the assessed markers (NLR, PLR).…”