CA19-9 as a predictor of recurrence in patients with colorectal cancer.
OBJECTIVE
CA19-9 is a cancer-associated carbohydrate antigen that plays a role in the process of tumor progression as an adhesion molecule.


METHODS
We evaluated the prognostic value of CA19-9 tumor expression and CA19-9 preoperative and postoperative serum levels in colorectal cancer patients treated by complete resection. The most powerful discrimination was achieved using the three CA19-9 markers in combination.


RESULTS
CA19-9 tumor expression was identified by immunostaining in 71.0% (86/121) of primary carcinomas. Positive CA19-9 serum levels (> or = 37 U/ml) were restricted to cases with positive tumor expression, and CA19-9 was detected more frequently in preoperative serum (20.6%, 25/121) than in 1-month postoperative serum (6.6%, 8/121). Positive tumor expression, positive preoperative serum level, and positive postoperative serum level were all predictive of increased cancer mortality. Patients with three negative parameters had no recurrences and 97.1% 5-year survival, whereas patients with three positive parameters had 62.5% recurrence and 42.8% 5-year survival.


CONCLUSIONS
CA19-9 detection in tumor tissue and serum identified patients at high risk of cancer recurrence and death and may be useful in selecting patients for adjuvant therapy.
Nakayama
T
T
Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Watanabe
M
M
Teramoto
T
T
Kitajima
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D003110:Colonic Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000276:immunology*; D011379:Prognosis; D011863:Radioimmunoassay; D012004:Rectal Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen