CEA and CA 19-9 as prognostic indexes in colorectal cancer.
Carcinoembryonic Antigen (CEA) and CA 19-9 are tumor markers expressed by colorectal cancers (CR), particularly in advanced cases. The aim of this study was to evaluate the prognostic value of pre-operative elevated CEA and/or CA 19-9 levels for patients with CR. Blood samples were collected from 74 patients. CEA and CA 19-9 were determined by ELISA (normal range: 0-3 ng/ml for CEA and 0-37 U/ml for CA 19-9). All patients were followed-up for at least 30 months or until death. At the time of diagnosis, 42% of the patients had elevated serum levels of CEA and 35% of CA 19-9. Relapse was observed in 33 patients, 73% of whom had elevated CEA and/or CA 19-9 levels. Among patients without relapse, 68% and 73% had normal values of CEA and CA 19-9, respectively. Ninety-three percent of patients, who had CR recurrence during the first year, had an elevated CEA and/or CA 19-9 level, while 67% of the patients with CR after 1 year, had normal tumor markers. Elevated pre-operative serum CEA and CA 19-9 levels were each predictive of increased cancer mortality (p = 0.001 for CEA, p = 0.01 for CA 19-9). Raised CEA and CA 19-9 levels identify patients at high risk for CR and death and may be useful in selecting patients for adjuvant therapy.
Forones
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Gastroenterology Division, Federal University of Sao Paulo, UNIFESP, Escola Paulista de Medicina, Brasil. nora@gastro.epm.br
Tanaka
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M
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen