The clinical significance of preoperative serum levels of carbohydrate antigen 19-9 in colorectal cancer

Abstract

PurposeCarcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) are the most frequently used tumor markers in the clinical setting of colorectal cancer (CRC). This study was designed to investigate the correlation between preoperative serum levels of CA 19-9 (pre-CA 19-9) and the clinicopathologic factors of patients with CRC.MethodsA study was performed on 333 patients with histologically diagnosed colorectal adenocarcinoma between December 2008 and November 2011, based on prospective collected data. The clinical data such as age, sex, location of tumor, size of tumor, differentiation, depth of tumor (T), lymph node metastasis (N), distant metastasis (M), lymphatic invasion, venous invasion, perineural invasion, stage, and preoperative serum levels of CEA (pre-CEA) and pre-CA 19-9 were obtained. These patients were classified into two groups according to pre-CA 19-9 (CA 19-9 high: >39 U/mL, n = 61 [18.3%]; CA 19-9 normal: <39 U/mL, n = 272 [81.7%]).ResultsSixty-one patients among 333 patients (18.3%) with CRC showed a high pre-CA 19-9. The elevation of pre-CA 19-9 was significantly associated with size of tumor (4.8 ± 0.1 cm vs. 6.1 ± 0.3 cm, P < 0.001), right colon cancer (P < 0.001), depth of tumor (P < 0.001), lymph node metastasis (P < 0.001), distant metastasis (P < 0.001), perineural invasion (P = 0.008), peritoneal seeding (P < 0.001), and stage (P < 0.001). On multivariate analysis, high pre-CA 19-9 was shown to be independently associated with high pre-CEA, lymph node metastasis, right colon cancer, large tumor size, and peritoneal seeding. There were twelve patients confirmed for peritoneal seeding among 333 patients (3.6%).ConclusionHigh pre-CA 19-9 in advanced colorectal cancer might provide important information to predict the possibility of peritoneal seeding.

Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume as potential biomarkers for early detection and monitoring of colorectal adenocarcinoma

“…It was also shown that an increase in CEA level implies a higher recurrence rate and worse prognosis (Wanebo et al, 1978). The overall reported incidences of high CA 19-9 levels in preoperative CRC patients range from 10.6 to 24.4% (Yu et al, 2013). In some previous studies, a high preoperative CA 19-9 level was shown to be independently associated with high pre-CEA, lymph node metastasis, large tumor size, and peritoneal seeding (Yang et al, 2004;Yu et al, 2013).…”

“…The overall reported incidences of high CA 19-9 levels in preoperative CRC patients range from 10.6 to 24.4% (Yu et al, 2013). In some previous studies, a high preoperative CA 19-9 level was shown to be independently associated with high pre-CEA, lymph node metastasis, large tumor size, and peritoneal seeding (Yang et al, 2004;Yu et al, 2013). However, the present data are insufficient to recommend CA 19-9 for staging, surveillance, or monitoring treatment of patients with CRC (Duffy et al, 2003).…”

A novel mixed integer programming for multi-biomarker panel identification by distinguishing malignant from benign colorectal tumors

“…However, individual biomarker lacks sensitivity and specificity [13][14][15]. CEA and CA199 are the most frequently used tumor biomarkers in the clinical diagnosis of CRC but the AUC of CEA (AUC = 0.6995) and CA199 (AUC = 0.6518) are low [23,24]. Besides that, LP(a) (AUC = 0.6942) is superior to CA199 and it is a risk factor for atherosclerotic diseases such as coronary heart disease and stroke.…”

Neoadjuvant Conformal Chemoradiation with Induction Chemotherapy for Rectal Adenocarcinoma. A Prospective Observational Study

“…It has been shown since the nineties that it is an independent prognostic factor [21] and is useful in metastatic disease [22]; recently its value has been demonstrated for follow-up [23]. Increased CA 19-9 has been correlated with high CEA, lymph node metastasis, right colon tumors, large tumor size and peritoneal seeding [24]. We have shown that CA 19-9 is more frequently increased in G3 tumors, independently of the (clinically established) stage.…”