Clinical Significance and Role of TK1, CEA, CA 19-9 and CA 72-4 levels in Diagnosis of Colorectal Cancers.

Swarnima Singh,Rakesh Kumar,Rekha Kumari,Uday Kumar

doi:10.31557/apjcp.2020.21.11.3133

Abstract

To explore the diagnostic value, pre-operative serum thymidine kinase 1(TK1), CEA, CA 19-9 and CA 72-4 levels were measured in 106 patients with colorectal carcinoma (53 colon and 53 rectal carcinoma patients) and 53 healthy controls. Sandwich Elisa, biotin-labeled antibody kit was used for TK1, and other tumor markers were measured using electro-chemiluminescence. Serum TK1 levels were significantly higher in CRC than in healthy controls (p<0.05) and showed significant associations with tumor stage, histopathological grade, lymph node status and metastasis (p<0.01). TK1 showed the highest (0.824-0.862) area under receiver operating characteristics curve (AUC) in comparison to other markers, and the AUC of the panel of combination tests performed even better (0.935-0.952). Significant variation was observed between the single biomarker test and their combination (Z test, p<0.01) and the Hosmer-Lemeshow test showed an adequate model of calibration. The algorithm based on combination of TK1, CEA, CA19-9 and CA72-4 can improve the diagnostic efficiency in CRC patients.

Highlights

Colorectal cancer (CRC) is a formidable health problem worldwide and the third common explanation for cancer death (GLOBOCAN, 2018 )
To explore the diagnostic value, pre-operative serum thymidine kinase 1(TK1), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9) and carbohydrate antigen 72-4 (CA 72-4) levels were measured in 106 patients with colorectal carcinoma (53 colon and 53 rectal carcinoma patients) and 53 healthy controls
The algorithm based on combination of TK1, CEA, cancer antigen 19-9 (CA19-9) and cancer antigen 72-4 (CA72-4) can improve the diagnostic efficiency in CRC patients

Summary

Introduction

Colorectal cancer (CRC) is a formidable health problem worldwide and the third common explanation for cancer death (GLOBOCAN, 2018 ). Endoscopic procedures (colonoscopy, sigmoidoscopy) and computed tomography (CT) colonography are used to diagnose CRC. Due to their complex techniques, high costs, requirement of repeating (3-5 years), they have poor compliance rates (Garborg et al, 2013; Anderson et al, 2011) especially in developing countries and rural areas. The blood-based tumor markers are being emphasized as simple, relatively inexpensive, reproducible, quantitative, and objective diagnostic tool. One such glycoprotein carcinoembryonic antigen (CEA) is widely used CRC molecular marker, but its association with other types of cancer (ovarian cancer, inflammatory bowel disease) has jeopardized its specificity (Yanfeng et al, 2018). Other serum markers like cancer antigen 19-9 (CA19-9) (Wang et al, 2002), cancer antigen 72-4 (CA72-4) (CarpelanHolmstrom et al, 2004), have been utilized for CRC diagnosis, post-operative surveillance, and treatment monitoring, but inconsistent results have been obtained

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Results

Conclusion