Clinical meaning of age-related expression of fecal cytokeratin 19 in colorectal malignancy.
BACKGROUND
Colorectal cancer (CRC) is one of the leading causes of malignant death worldwide. Because young age of onset is often considered a poor prognostic factor for CRC, it is important to identify the poor outcomes of CRC in a younger population and to consider an aggressive approach by implementing early treatment. Our aim was to specifically quantify the fecal cytokeratin 19 (CK19) transcript from CRC patients and investigate its correlation with clinical stage, tumor malignancy, and age.


METHODS
The quantitation of fecal CK19 transcript was determined by a quantitative real-time reverse transcription polymerase chain in 129 CRC patients (45 younger than 60 years at diagnosis) and 85 healthy controls. The levels of CK19 protein were examined both in colonic cell lines and tissues.


RESULTS
The analysis of 45 younger CRC patients (age <or= 60 years) revealed that patients at the M1 stage had significantly higher expression levels of fecal CK19 mRNA when compared with healthy controls (p < 0.001) and patients at the M0 stage (p = 0.004). Additionally, the degree of consistency between the mean level of fecal CK19 mRNA and the distant metastatic rate in each age interval was up to 89% (p = 0.042).


CONCLUSIONS
These results indicate that high levels of fecal CK19 mRNA represent a potential marker for colorectal malignancy and for aggressive treatment of younger CRC patients.
Digestive Disease Research Center, Taipei Medical University and Division of Gastroenterology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan, Republic of China. chunchao@tmu.edu.tw
Chun-Chao
CC
Chang
Shung-Haur
SH
Yang
Chih-Cheng
CC
Chien
Shu-Hung
SH
Chen
Shiann
S
Pan
Chia-Long
CL
Lee
Chih-Ming
CM
Lin
Hsiao-Lun
HL
Sun
Chi-Cheng
CC
Huang
Yih-Yiing
YY
Wu
Ruey-Neng
RN
Yang
Chi-Jung
CJ
Huang
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D045744:Cell Line, Tumor; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053539:Keratin-19 / Q000235:genetics* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000378:metabolism*
D053539:Keratin-19