title: Upregulation of fecal cytokeratin 19 is associated with prognosis in older colorectal cancer patients.
abstract: The upregulation of fecal cytokeratin 19 (CK19) correlates with age and metastatic status in human colorectal cancer (CRC). To further explore its clinical significance in older patients (>60 years), their fecal CK19 was measured by quantitative reverse transcription-polymerase chain reaction. Differences in CK19 transcripts were compared using the nonparametric Mann-Whitney U test. Clinical significance was assessed with the chi-squared test and a binary logistic regression model. The association between overall survival and expressions of fecal CK19 in combination with other serum markers, carcinoembryonic antigen and carbohydrate antigen 19-9 (CA19-9), was evaluated using the Kaplan-Meier method. In these older groups, CRC patients had significantly higher median fecal CK19 expression (p = 0.006) than controls. The highest risk of CRC (odds ratio, 5.8; 95% confidence interval, 2.3-14.7; p < 0.001) was detected when the cutoff value for fecal CK19 expression was set at the median value of the 28 healthy controls. The lowest overall survival (29.2% ± 21.4%) occurred in patients in whom serum CA19-9 levels were high and fecal CK19 was overexpressed. Our results suggest that fecal CK19 expression is associated with CRC, and together with serum carcinoembryonic antigen or CA19-9, it can predict overall survival in older patients.
authors.affiliation: Department of Internal Medicine, Sijhih Cathay General Hospital, Sijhih City, Taipei, Taiwan.
authors.forename: Ruey-Neng
authors.initials: RN
authors.lastname: Yang
authors.forename: Shung-Haur
authors.initials: SH
authors.lastname: Yang
authors.forename: Chun-Chao
authors.initials: CC
authors.lastname: Chang
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Chien
authors.forename: Shiann
authors.initials: S
authors.lastname: Pan
authors.forename: Chi-Jung
authors.initials: CJ
authors.lastname: Huang
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000235:genetics / Q000378:metabolism* / Q000401:mortality; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis / Q000096:biosynthesis* / Q000235:genetics; D018395:CA-19-9 Antigen / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D015179:Colorectal Neoplasms / Q000097:blood / Q000235:genetics / Q000378:metabolism* / Q000401:mortality; D005243:Feces / Q000737:chemistry*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053208:Kaplan-Meier Estimate; D053539:Keratin-19 / Q000096:biosynthesis* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018709:Statistics, Nonparametric; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D053539:Keratin-19