title: Differential expression of carbohydrate antigen 19-9 in human colorectal cancer: A comparison with colon and rectal cancers.
abstract: Colorectal cancer is one of the leading causes of cancer-related mortality, being the third most commonly diagnosed cancer among men and the second among women. Accumulating evidence regarding carbohydrate antigen (CA) demonstrated that tumor-associated antigens are clinically useful for the diagnosis, staging and monitoring of human gastrointestinal cancers, particularly colorectal cancer. There has been an extensive investigation for sensitive and specific markers of this disease. Currently, the gastrointestinal cancer-associated carbohydrate antigen 19-9 (CA19-9) is the most widely applied tumor marker in cancer diagnosis. Despite a similar etiology and cancer incidence rates, there are anatomical and clinical differences between colon and rectal cancer, as well as differences regarding tumor progression and adjuvant treatments. To investigate whether CA19-9 is differentially expressed between colon and rectal cancer, we conducted a differential analysis of serum CA19-9 levels among 227 cases of colorectal cancer, analyzing gender, age, Dukes' stage and distant metastasis for human colon and rectal cancer as a single entity, separately and as matched pairs. We demonstrated that the serum CA19-9 levels in colorectal cancer were upregulated in advanced stages with distant metastasis. By contrast, the serum CA19-9 levels in colon cancer displayed a differential and upregulated behavior in advanced stages with distant metastasis. By analyzing as matched pairs, the upregulated serum CA19-9 levels in rectal cancer during the early stages without distant metastasis further supported our hypothesis that the expression of CA19-9 displays a site-specific differential behavior. The integrative analysis suggested a significant difference between human colon and rectal cancer, justifying individualized therapy for these two types of cancer.
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023; ; Department of Clinical Biochemistry, Dalian Medical University, Dalian, Liaoning 116044, P.R. China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023; ; Department of Clinical Biochemistry, Dalian Medical University, Dalian, Liaoning 116044, P.R. China.
authors.forename: Yijun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023; ; Department of Clinical Biochemistry, Dalian Medical University, Dalian, Liaoning 116044, P.R. China.
authors.forename: Zhanmeng
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023; ; Department of Clinical Biochemistry, Dalian Medical University, Dalian, Liaoning 116044, P.R. China.
authors.forename: Yunlong
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023;
authors.forename: Shuangyi
authors.initials: S
authors.lastname: Ren
authors.affiliation: Department of Clinical Biochemistry, Dalian Medical University, Dalian, Liaoning 116044, P.R. China.
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Zuo
keywords: carbohydrate antigen 19-9; colorectal cancer; tumor marker