Differential expression of carbohydrate antigen 19-9 in human colorectal cancer: A comparison with colon and rectal cancers

Abstract

Abstract. Colorectal cancer is one of the leading causes of cancer-related mortality, being the third most commonly diagnosed cancer among men and the second among women. Accumulating evidence regarding carbohydrate antigen (CA) demonstrated that tumor-associated antigens are clinically useful for the diagnosis, staging and monitoring of human gastrointestinal cancers, particularly colorectal cancer. There has been an extensive investigation for sensitive and specific markers of this disease. Currently, the gastrointestinal cancer-associated carbohydrate antigen 19-9 (CA19-9) is the most widely applied tumor marker in cancer diagnosis. Despite a similar etiology and cancer incidence rates, there are anatomical and clinical differences between colon and rectal cancer, as well as differences regarding tumor progression and adjuvant treatments. To investigate whether CA19-9 is differentially expressed between colon and rectal cancer, we conducted a differential analysis of serum CA19-9 levels among 227 cases of colorectal cancer, analyzing gender, age, Dukes' stage and distant metastasis for human colon and rectal cancer as a single entity, separately and as matched pairs. We demonstrated that the serum CA19-9 levels in colorectal cancer were upregulated in advanced stages with distant metastasis. By contrast, the serum CA19-9 levels in colon cancer displayed a differential and upregulated behavior in advanced stages with distant metastasis. By analyzing as matched pairs, the upregulated serum CA19-9 levels in rectal cancer during the early stages without distant metastasis further supported our hypothesis that the expression of CA19-9 displays a site-specific differential behavior. The integrative analysis suggested a significant difference between human colon and rectal cancer, justifying individualized therapy for these two types of cancer.

Mucins and associated glycan signatures in colon adenoma–carcinoma sequence: Prospective pathological implication(s) for early diagnosis of colon cancer

“…Although the diagnostic sensitivity and specificity of CA 19-9 for CRC has been estimated to be 70% and 61%, respectively [47], our results underscore the inability of CA 19-9 assays to differentiate normal and inflammatory colon from adenocarcinoma, despite its increase in expression in 75% of tissues. Since the elevated CA 19-9 levels correlate with tumor stage and with the highest sensitivity in patients with metastases [48], it may serve as a useful marker for advanced disease.…”

Expression of KRAS in tissue samples of colorectal carcinoma and its correlation with various histo-pathological parameters.

“…5 In Pakistan CRC accounts for 52% of all gastrointestinal tumors. 6,7 Both environmental and genetic factors as well as various molecular pathways like chromosomal instability (CIN), microsatellite instability (MSI), and the CpG island methylation phenotype (CIMP) are responsible for the pathogenesis of colorectal cancer. These pathways are mediated by some important tumor suppressor genes and proto-oncogene.…”