Cancer Antigens (CEA and CA 19-9) as Markers of Advanced Stage of Colorectal Carcinoma

Abstract

Introduction:CEA and CA 19-9 are the most common tumor associated antigens used in the staging of patients with rectal cancer and other parts of the colon.Goal:of this study was to evaluate the value of CEA and CA 19-9 in serum of patients with colon cancer and prove its place in the diagnostic staging.Material and Methods:The study was retrospective-prospective performed at the Gastroenterohepatology Clinic, Clinical Center of Sarajevo University. The study included 91 hospitalized patients who had histologically confirmed diagnosis of colon adenocarcinoma in 98% of cases. All patients underwent colonoscopy, targeted biopsy and measurement of CEA and CA 19-9 levels in serum. All of them underwent abdominal CT and MRI of the pelvis in case of rectal cancer.Results:The study analyzed 58 men and 33 women, mean age 66.6 years, with the youngest patient at age of 35 and the oldest at age of 89 years. The largest number of patients was aged 56-75 years. According to localization 77 patients had carcinoma located in the area of the rectum and sigma 37.4 and 37.4 in the rectostigmoid area and sigma. Metastases were observed in 37 patients, with predominance in the liver (22 cases) and both liver and lungs (5 cases). CEA and CA 19-9 were determined in all cases but patients with metastases had high values, especially in the two cases of cecoascendent colon cancer where detected values were extremely high (1789ng/ml and 10780U/ml). Values of CA19 -9 were significantly higher (p<0.05). CEA mean values were highest in patients aged over 75 years. In case of CA 19-9 high mean values have been recorded in patients aged over 75 years with statistically significant differences between the age groups (p<0.05).Conclusion:CEA and CA19-9 are cancer antigens that are late markers of carcinogenesis, with significantly elevated serum concentrations in case of colon cancer with already developed metastases. Older age group of patient has significantly elevated levels of both antigens. Cancer was twice more common in men than in women.

Selectin Ligands Sialyl-Lewis a and Sialyl-Lewis x in Gastrointestinal Cancers

“…At present, the actual expression of sLe antigens in native gastrointestinal cancers is not adequately known because of the little available data [151,152], potentially affected by artifacts [127,128,141]. Particularly, in colon cancer evidence of the expression of genuine CA19.9 is missing, and elevation of the circulating antigen is reported mainly in advanced stages of the disease [153,154]. In none of cases reported in vivo was any information available about the nature of the carrier molecules.…”

Blood circulating tumor DNA for non‐invasive genotyping of colon cancer patients

“…As mentioned in the introduction, the Response Evaluation Criteria In Solid Tumors (RECIST) (Eisenhauer et al., 2009), utilizes lesion size, to assess tumor burden and response to therapy. RECIST measurements are associated with serum biomarkers, such as CEA and CA19.9 in colorectal cancer (Vukobrat‐Bijedic et al., 2013). ctDNA half‐life is less than 2 h (Diaz and Bardelli, 2014), and changes in its levels can therefore be evident days or weeks before tumor shrinkage could be assessed by imaging or in protein biomarkers.…”

“…Early detection of CRC greatly improves the chances of cure. Several approaches including colonoscopy, evaluation of serum markers as carcinoembryonic antigen (CEA) and carbohydrate antigen 19‐9 (CA19‐9) (Vukobrat‐Bijedic et al., 2013), together with Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans (Sun et al., 2008) are used to diagnose CRC. The use of CEA or CA19‐9 is limited by the lack of sensitivity and specificity of these markers (Ludwig and Weinstein, 2005).…”

Predictive value of carcinoembryonic antigen and carbohydrate antigen 19-9 related to downstaging to stage 0&ndash;I after neoadjuvant chemoradiotherapy in locally advanced rectal cancer

“…Accurate prediction of the response to nCRT is still under investigation. Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) are cancer antigens that might elevated in the serum of patients with colorectal cancer and has been routinely used in the staging of patients with rectal cancer 12–14. There have been some reports investigating whether pretreatment CEA and CA 19-9 level could predict pathological responses to nCRT in rectal cancer 15–17.…”