title: Predictive Value of Carcinoembryonic and Carbohydrate Antigen 19-9 Related to Some Clinical, Endoscopic and Histological Colorectal Cancer Characteristics.
abstract: BACKGROUND
  Colorectal cancer (CRC) is an important oncological and public health problem worldwide, including Serbia. Unfortunately, half of the patients are recognized in an advanced stage of the disease, therefore, early detection through specific tumor biomarkers, such as carcinoembryonic (CEA) and carbohydrate antigen 19-9 (CA 19-9), is the only way to cope with CRC expansion.
  
  
  METHODS
  Our cross-sectional study evaluated the influence of some clinical, endoscopic and histological characteristics of CRC on CEA and CA 19-9 serum levels, to determine whether these biomarkers could be related to CRC detection. The study included 372 participants: 181 suffered from CRC and 191 participants were controls. Endoscopic and histological examinations were used for CRC diagnosis, while additional ultrasound and abdominal computerised tomography imaging were used for staging the disease. Measurement of CEA and CA 19-9 was performed after CRC confirmation.
  
  
  RESULTS
  Age, gender, tumor localization, macro-morphological and histological characteristics did not influence biomarkers serum levels. Both were significantly higher (p<0.01) in patients with Dukes D stage of CRC compared with controls. Sensitivity (76.8%) and specificity (76.6%) of CEA alone were higher than for CA 19-9, but with no statistical significance. Furthermore, sensitivity of CEA alone in the Dukes A/B group was similar to the entire CRC patient group.
  
  
  CONCLUSIONS
  Although not recommended as a screening method for the general population, elevated values of each biomarker indicate further diagnostic procedures and their simultaneous testing can improve the diagnostic sensitivity in early detection of CRC, as shown by the united analysis (AUC 0.842).
authors.affiliation: Clinical Hospital Center Zemun, Belgrade, Clinic of Internal Medicine, University of Belgrade, School of Medicine.
authors.forename: Ratko
authors.initials: R
authors.lastname: Tomašević
authors.affiliation: Clinical Center of Serbia, Gastroenterology and Hepatology Clinic, University of Belgrade, School of Medicine.
authors.forename: Tomica
authors.initials: T
authors.lastname: Milosavljević
authors.affiliation: Clinical Hospital Center Zemun, Belgrade, Surgery Clinic, University of Belgrade, School of Medicine.
authors.forename: Dragoš
authors.initials: D
authors.lastname: Stojanović
authors.affiliation: Clinical Hospital Center Zemun, Belgrade, Clinic of Internal Medicine, University of Belgrade, School of Medicine.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Gluvić
authors.affiliation: Clinical Hospital Center Zemun, Belgrade, Clinic of Internal Medicine, University of Belgrade, School of Medicine.
authors.forename: Predrag
authors.initials: P
authors.lastname: Dugalić
authors.affiliation: Clinical Hospital Center Zemun, Belgrade, Clinic of Internal Medicine, University of Belgrade, School of Medicine.
authors.forename: Ivan
authors.initials: I
authors.lastname: Ilić
authors.affiliation: Clinical Hospital Center Zemun, Belgrade, Clinic of Internal Medicine, University of Belgrade, School of Medicine.
authors.forename: Radosav
authors.initials: R
authors.lastname: Vidaković
keywords: carbohydrate antigen 19-9; carcinoembryonic antigen; colorectal cancer; tumor markers