Current status of tumor markers in large bowel cancer

Abstract

The aim of a primary screening system is to detect premalignant lesions and carcinomas when amenable to "curative" surgery. Although a number of "classical" tumor markers have acquired potential for clinical management, none is presently adequate for presymptomatic diagnosis or screening. In colorectal carcinoma, the screening potential of carcinoembryonic antigen (CEA), the gastrointestinal-related antigen, CA19-9, and other more recently characterized "biochemical markers" is virtually nonexistent, even in patients at high risk to develop the disease. Promising new leads are beginning to emerge from somatic cell genetic and molecular biological approaches. In common with other epithelial neoplasms, perturbations in oncogene expression have been demonstrated in colorectal cancers, and probably reflect important events in malignant transformation and progression. Studies of oncogene expression have, however, not yet yielded clinically useful information. Recently, an intensive search for specific chromosomal and gene abnormalities in the hereditary colon cancer syndromes led to the location of the familial adenomatous polyposis (FAP) gene at chromosome 5q21-q22. Significant is that the loss of alleles on chromosome 5 has also been observed in the tumor cells of at least 20% of sporadic colon cancer patients. This type of association between constitutional genetic change and genetic aberration in the cells of sporadic tumors is reminiscent of other malignant diseases with a genetic component (e.g., retinoblastoma and Wilms' tumor).(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of four serum tumour markers in the diagnosis of colorectal carcinoma

“…Organspecificity was not investigated in the present study, but the tumour-specificity is disappointing. Even CA 50, which has been reported to be tumour-specific (Holmgren et al, 1984) does not show a better discriminative ability than CEA, which is known to be increased in nonmalignant disorders and healthy smokers (Moore et al, 1989) (Fukuta et al, 1987). This is not confirmed by the present study.…”

Carcinoma of Caecum Presenting as Mega Intussusception and Rectal Mass

“…However, abnormally high levels of CEA are also found in sera of patients with other gastrointestinal cancers (stomach, liver etc.) 8 . On imaging studies through barium enema examination, lesions of the right colon may appear as a constriction or an intramural mass.…”

Μελέτη του ρόλου των μορίων αξίνης-2 (Axin-2) β-κατενίνης (β-catenin) και Ε-καδχερίνης (E-cadherin) στην κυτταρική προσκόλληση και στον παθογενετικό μηχανισμό της μετάστασης σε πρωτοπαθή καρκινώματα του παχέος εντέρου

“…μετεγχειρητικά η τακτική παρακολούθηση των επιπέδων του πρέπει να ξεκινά μετά από 3 μήνες. Επίπεδα CEA τα οποία ομαλοποιήθηκαν άμεσα μετεγχειρητικά και άρχισαν να αυξάνονται πάλι μετά από κάποιο διάστημα, θέτουν την υπόνοια υποτροπής της νόσου 177,[210][211][212][213]. Συμπερασματικά λοιπόν και σύμφωνα πάντα με τις πρόσφατες συστάσεις της ASCO, τα προεγχειρητικά επίπεδα του CEA χρησιμεύουν στον καθορισμό της χειρουργικής θεραπείας, στην εκτίμηση της πρόγνωσης και στο να υπάρχει μία προεγχειρητική τιμή αναφοράς, με την οποία να μπορούν να συγκριθούν οι μετεγχειρητικές τιμές στο καθορισμένο πλάνο follow up του ασθενούς 214.…”