Serum CEA and CA 19-9 Levels Are Associated with the Presence and Severity of Colorectal Neoplasia

Overview

Journal Yonsei Med J

Specialty General Medicine

Date 2017 Aug 10

PMID 28792134

Citations 29

Authors

Nam Hee Kim

Mi Yeon Lee

Jung Ho Park

Dong Il Park

Chong Il Sohn

Kyuyong Choi

Yoon Suk Jung

Affiliations

Soon will be listed here.

Abstract

Purpose: Limited data are available regarding the association between circulating serum carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA 19-9) concentrations and colorectal adenoma. We aimed to investigate whether elevated serum CEA and CA 19-9 levels are correlated with the presence of colorectal neoplasia (CRN) and whether the levels of these antigens vary according to CRN severity.

Materials And Methods: A cross-sectional study was performed on asymptomatic subjects who underwent colonoscopy between 2010 and 2014 as part of a comprehensive health screening program in Korea.

Results: A total of 124509 participants with measured serum CEA levels and 115833 participants with measured serum CA 19-9 levels were analyzed. Elevated CEA concentrations were associated with a higher rate of any adenoma, advanced adenoma, high-risk adenoma, advanced CRN (ACRN), overall CRN, and colorectal cancer (CRC). Elevated CA 19-9 concentrations were also associated with a higher rate of advanced adenoma, high-risk adenoma, ACRN, and CRC. Both elevated levels of CEA and CA 19-9 were identified as independent predictors of ACRN. Among patients with CRN, the proportions of elevated CEA/CA 19-9 levels were significantly higher in patients with ACRN than in those with non-ACRN, and these levels were correlated with larger lesion size and multiplicity of adenomas.

Conclusion: Both elevated serum CEA and CA 19-9 levels were associated with the presence of ACRN, as well as CRC. Elevated CEA levels were also associated with the presence of overall CRN. Moreover, both CEA and CA 19-9 levels were correlated with the severity of CRN.

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References

Kim Y, Noh R, Cho S, Park S, Jeon S, Shin H . Inhibitory effect of metformin therapy on the incidence of colorectal advanced adenomas in patients with diabetes. Intest Res. 2015; 13(2):145-52. PMC: 4414756. DOI: 10.5217/ir.2015.13.2.145. View

Stiksma J, Grootendorst D, van der Linden P . CA 19-9 as a marker in addition to CEA to monitor colorectal cancer. Clin Colorectal Cancer. 2014; 13(4):239-44. DOI: 10.1016/j.clcc.2014.09.004. View

Magnani J . The discovery, biology, and drug development of sialyl Lea and sialyl Lex. Arch Biochem Biophys. 2004; 426(2):122-31. DOI: 10.1016/j.abb.2004.04.008. View

Wang Y, Yan J, Wang L . The diagnostic value of serum carcino-embryonic antigen, alpha fetoprotein and carbohydrate antigen 19-9 for colorectal cancer. J Cancer Res Ther. 2015; 10 Suppl:307-9. DOI: 10.4103/0973-1482.151538. View

Inra J, Syngal S . Colorectal cancer in young adults. Dig Dis Sci. 2014; 60(3):722-33. DOI: 10.1007/s10620-014-3464-0. View

Morson B . President's address. The polyp-cancer sequence in the large bowel. Proc R Soc Med. 1974; 67(6 Pt 1):451-7. PMC: 1645739. View

Soweid A, Kobeissy A, Jamali F, El-Tarchichi M, Skoury A, Abdul-Baki H . A randomized single-blind trial of standard diet versus fiber-free diet with polyethylene glycol electrolyte solution for colonoscopy preparation. Endoscopy. 2010; 42(8):633-8. DOI: 10.1055/s-0029-1244236. View

Fischbach W, Mossner J . Do size, histology, or cytology of colorectal adenomas and their removal influence serum CEA?. Dis Colon Rectum. 1987; 30(8):595-9. DOI: 10.1007/BF02554805. View

Scurr M, Brown C, Bento D, Betts G, Rees B, Hills R . Assessing the prognostic value of preoperative carcinoembryonic antigen-specific T-cell responses in colorectal cancer. J Natl Cancer Inst. 2015; 107(4). PMC: 4394893. DOI: 10.1093/jnci/djv001. View

10.

Prager G, Braemswig K, Martel A, Unseld M, Heinze G, Brodowicz T . Baseline carcinoembryonic antigen (CEA) serum levels predict bevacizumab-based treatment response in metastatic colorectal cancer. Cancer Sci. 2014; 105(8):996-1001. PMC: 4317865. DOI: 10.1111/cas.12451. View

11.

Lieberman D, Rex D, Winawer S, Giardiello F, Johnson D, Levin T . Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012; 143(3):844-857. DOI: 10.1053/j.gastro.2012.06.001. View

12.

Salces I, Vegh I, Rodriguez-Munoz S, Colina F, Perez A, Soto S . Tissue CA-19.9 content in colorectal adenomas and its value in the assessment of dysplasia. Rev Esp Enferm Dig. 2004; 96(4):246-54. DOI: 10.4321/s1130-01082004000400003. View

13.

Wen C, Cheng T, Tsai S, Chan H, Hsu H, Hsu C . Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutr. 2008; 12(4):497-506. DOI: 10.1017/S1368980008002802. View

14.

Hamaguchi M, Kojima T, Itoh Y, Harano Y, Fujii K, Nakajima T . The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation. Am J Gastroenterol. 2007; 102(12):2708-15. DOI: 10.1111/j.1572-0241.2007.01526.x. View

15.

Duffy M, van Dalen A, Haglund C, Hansson L, Klapdor R, Lamerz R . Clinical utility of biochemical markers in colorectal cancer: European Group on Tumour Markers (EGTM) guidelines. Eur J Cancer. 2003; 39(6):718-27. DOI: 10.1016/s0959-8049(02)00811-0. View

16.

Palmqvist R, Engaras B, Lindmark G, Hallmans G, Tavelin B, Nilsson O . Prediagnostic levels of carcinoembryonic antigen and CA 242 in colorectal cancer: a matched case-control study. Dis Colon Rectum. 2003; 46(11):1538-44. DOI: 10.1007/s10350-004-6810-z. View

17.

Sung J, Lau J, Goh K, Leung W . Increasing incidence of colorectal cancer in Asia: implications for screening. Lancet Oncol. 2005; 6(11):871-6. DOI: 10.1016/S1470-2045(05)70422-8. View

18.

Bailey C, Hu C, You Y, Bednarski B, Rodriguez-Bigas M, Skibber J . Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975-2010. JAMA Surg. 2014; 150(1):17-22. PMC: 4666003. DOI: 10.1001/jamasurg.2014.1756. View

19.

Park I, Choi G, Jun S . Prognostic value of serum tumor antigen CA19-9 after curative resection of colorectal cancer. Anticancer Res. 2009; 29(10):4303-8. View

20.

Ferlay J, Shin H, Bray F, Forman D, Mathers C, Parkin D . Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2011; 127(12):2893-917. DOI: 10.1002/ijc.25516. View