J Med Biochem 2016; 35 (3)
DOI: 10.1515/jomb-2016-0014
UDK 577.1 : 61
ISSN 1452-8258
J Med Biochem 35: 324 –332, 2016
Original paper Originalni nau~ni rad
PREDICTIVE VALUE OF CARCINOEMBRYONIC AND CARBOHYDRATE ANTIGEN 19-9 RELATED TO SOME CLINICAL, ENDOSCOPIC AND HISTOLOGICAL COLORECTAL CANCER CHARACTERISTICS PREDIKTIVNE VREDNOSTI KARCINOEMBRIONSKOG I KARBOHIDRATNOG ANTIGENA 19-9 U ODNOSU NA NEKE KLINI^KE, ENDOSKOPSKE I HISTOLO[KE KARAKTERISTIKE KOLOREKTALNOG KANCERA Ratko Toma{evi}1, Tomica Milosavljevi}2, Drago{ Stojanovi}3, Zoran Gluvi}1, Predrag Dugali}1, Ivan Ili}1, Radosav Vidakovi}1 1Clinical
Hospital Center Zemun, Belgrade, Clinic of Internal Medicine, University of Belgrade, School of Medicine 2Clinical Center of Serbia, Gastroenterology and Hepatology Clinic, University of Belgrade, School of Medicine 3Clinical Hospital Center Zemun, Belgrade, Surgery Clinic, University of Belgrade, School of Medicine
Summary
Kratak sadr`aj
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 (p35.4 (U/mL)
Patients
181
10.29 (7.82–13.56)
102 (56.3%)
28.79 (22.59–36.71)
67 (37.0%)
Female
72 (39.8%)
10.45 (7.13–15.31)
41 (37.6%)
28.44 (20.38–39.69)
27 (24.8%)
Male
109 (60.2%)
10.07 (6.81–14.88)
61 (84.7%)
29.34 (20.61–41.76)
40 (55.6%)
≤60 years
45 (24.9%)
8.62 (5.31–13.98)
22 (48.9%)
23.79 (15.34–36.88)
14 (31.1%)
61–70 years
74 (40.9%)
11.21 (7.05–17.84)
41 (55.4%)
23.84 (16.56–34.32)
30 (40.5%)
>70 years
62 (34.2%)
10.63 (7.05–17.84)
39 (62.9%)
41.08 (25.79–65.46)
23 (37.1%)
Age
Tumor stage – Dukes A/B
43 (23.8%)
4.12 (2.84–5.97)
13 (30.2%)
13.66 (10.78–17.32)
4 (9.3%)
C
70 (38.7%)
5.19 (3.81–7.07)
38 (54.3%)
17.35 (12.71–23.70)
18 (25.7%)
D
68 (37.6%)
37.22 (22.77–60.84) **
51 (75.0%) **
77.72 (49.09–123.03) ** 45 (66.2%) **
Histological examination (report) Poorly differentiated
16 (8.8%)
7.69 (3.00–19.72)
7 (43.7%)
27.03 (11.29–64.74)
6 (37.5%)
Moderately differentiated
108 (59.7%)
10.99 (7.63–15.82)
64 (59.2%)
28.45 (20.53–39.44)
42 (38.9%)
Well differentiated
57 (31.5%)
9.87 (6.02–16.20)
31 (54.4%)
29.98 (19.74–45.54)
19 (33.3%)
Macroscopic tumor appearance Luminal stenosis
90 (49.7%)
12.51 (8.48–18.43)
56 (62.2%)
25.99 (18.38–36.73)
30 (33.3%)
Polypoid type
76 (42.0%)
8.35 (5.32–13.11)
37 (48.7%)
29.93 (20.58–43.51)
31 (40.8%)
Ulcerative type
15 (8.3%)
9.24 (4.05–21.07)
9 (60.0%)
43.86 (16.25–118.40)
6 (40.0%)
Rectum
60 (33.2%)
11.21 (6.93–18.14)
35 (58.3%)
32.00 (20.81–49.20)
23 (38.3%)
Left colon
70 (38.7%)
12.26 (7.61–19.75)
40 (57.1%)
24.76 (16.54–37.06)
29 (41.4%)
Right colon
51 (28.1%)
7.33 (4.54–11.84)
27 (52.9%)
31.30 (19.92–49.21)
15 (29.4%)
Yes
130 (71.8%)
13.75 (9.86–19.17) **
86 (66.2%) **
36.42 (26.91–49.30) **
62 (47.7%)**
No
51 (28.2%)
4.18 (2.90–6.02)
16 (31.4%)
13.85 (10.97–17.50)
5 (9.8%)
21.77 (17.39–27.26)
48 (30.0%) **
Tumor localization
Metastases
Colon cancer surgery Yes
160 (88.4%)
7.73 (6.01–9.95)
86 (53.7%)
No
21 (11.6%)
91.34 (31.82–262.19) **
16 (76.2%) *
242.4 (113.5–517.3) ** 19 (90.5%) **
Continuous variables are expressed as geometric mean and 95% confidence interval derived from log–normal distribution. Categorical variables are expressed as absolute and relative frequencies *p
DOI: 10.1515/jomb-2016-0014
UDK 577.1 : 61
ISSN 1452-8258
J Med Biochem 35: 324 –332, 2016
Original paper Originalni nau~ni rad
PREDICTIVE VALUE OF CARCINOEMBRYONIC AND CARBOHYDRATE ANTIGEN 19-9 RELATED TO SOME CLINICAL, ENDOSCOPIC AND HISTOLOGICAL COLORECTAL CANCER CHARACTERISTICS PREDIKTIVNE VREDNOSTI KARCINOEMBRIONSKOG I KARBOHIDRATNOG ANTIGENA 19-9 U ODNOSU NA NEKE KLINI^KE, ENDOSKOPSKE I HISTOLO[KE KARAKTERISTIKE KOLOREKTALNOG KANCERA Ratko Toma{evi}1, Tomica Milosavljevi}2, Drago{ Stojanovi}3, Zoran Gluvi}1, Predrag Dugali}1, Ivan Ili}1, Radosav Vidakovi}1 1Clinical
Hospital Center Zemun, Belgrade, Clinic of Internal Medicine, University of Belgrade, School of Medicine 2Clinical Center of Serbia, Gastroenterology and Hepatology Clinic, University of Belgrade, School of Medicine 3Clinical Hospital Center Zemun, Belgrade, Surgery Clinic, University of Belgrade, School of Medicine
Summary
Kratak sadr`aj
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 (p35.4 (U/mL)
Patients
181
10.29 (7.82–13.56)
102 (56.3%)
28.79 (22.59–36.71)
67 (37.0%)
Female
72 (39.8%)
10.45 (7.13–15.31)
41 (37.6%)
28.44 (20.38–39.69)
27 (24.8%)
Male
109 (60.2%)
10.07 (6.81–14.88)
61 (84.7%)
29.34 (20.61–41.76)
40 (55.6%)
≤60 years
45 (24.9%)
8.62 (5.31–13.98)
22 (48.9%)
23.79 (15.34–36.88)
14 (31.1%)
61–70 years
74 (40.9%)
11.21 (7.05–17.84)
41 (55.4%)
23.84 (16.56–34.32)
30 (40.5%)
>70 years
62 (34.2%)
10.63 (7.05–17.84)
39 (62.9%)
41.08 (25.79–65.46)
23 (37.1%)
Age
Tumor stage – Dukes A/B
43 (23.8%)
4.12 (2.84–5.97)
13 (30.2%)
13.66 (10.78–17.32)
4 (9.3%)
C
70 (38.7%)
5.19 (3.81–7.07)
38 (54.3%)
17.35 (12.71–23.70)
18 (25.7%)
D
68 (37.6%)
37.22 (22.77–60.84) **
51 (75.0%) **
77.72 (49.09–123.03) ** 45 (66.2%) **
Histological examination (report) Poorly differentiated
16 (8.8%)
7.69 (3.00–19.72)
7 (43.7%)
27.03 (11.29–64.74)
6 (37.5%)
Moderately differentiated
108 (59.7%)
10.99 (7.63–15.82)
64 (59.2%)
28.45 (20.53–39.44)
42 (38.9%)
Well differentiated
57 (31.5%)
9.87 (6.02–16.20)
31 (54.4%)
29.98 (19.74–45.54)
19 (33.3%)
Macroscopic tumor appearance Luminal stenosis
90 (49.7%)
12.51 (8.48–18.43)
56 (62.2%)
25.99 (18.38–36.73)
30 (33.3%)
Polypoid type
76 (42.0%)
8.35 (5.32–13.11)
37 (48.7%)
29.93 (20.58–43.51)
31 (40.8%)
Ulcerative type
15 (8.3%)
9.24 (4.05–21.07)
9 (60.0%)
43.86 (16.25–118.40)
6 (40.0%)
Rectum
60 (33.2%)
11.21 (6.93–18.14)
35 (58.3%)
32.00 (20.81–49.20)
23 (38.3%)
Left colon
70 (38.7%)
12.26 (7.61–19.75)
40 (57.1%)
24.76 (16.54–37.06)
29 (41.4%)
Right colon
51 (28.1%)
7.33 (4.54–11.84)
27 (52.9%)
31.30 (19.92–49.21)
15 (29.4%)
Yes
130 (71.8%)
13.75 (9.86–19.17) **
86 (66.2%) **
36.42 (26.91–49.30) **
62 (47.7%)**
No
51 (28.2%)
4.18 (2.90–6.02)
16 (31.4%)
13.85 (10.97–17.50)
5 (9.8%)
21.77 (17.39–27.26)
48 (30.0%) **
Tumor localization
Metastases
Colon cancer surgery Yes
160 (88.4%)
7.73 (6.01–9.95)
86 (53.7%)
No
21 (11.6%)
91.34 (31.82–262.19) **
16 (76.2%) *
242.4 (113.5–517.3) ** 19 (90.5%) **
Continuous variables are expressed as geometric mean and 95% confidence interval derived from log–normal distribution. Categorical variables are expressed as absolute and relative frequencies *p
