Abstract
Aim. The aim of this study is to determine the significance of postoperative sequential measurements of serum CA19-9 in patients with extremely low serum level. Patients and Methods. Serum level of CA19-9 of 1096 patients who underwent surgery was measured preoperatively and every three months after surgery for 5 years. Patients with CA19-9 level of less than 2 U/mL at the time of diagnosis were defined as Extremely Low CA19-9 (ELCA). Results. One hundred and seven patients (9.8%) were ELCA. Of these, 86 underwent surgery with curative intent. Serum levels of CA19-9 in patients who did not undergo curative resection (N = 12) and who developed recurrence (N = 10) were less than 2.0 U/mL in all occasions during followup. In all patients without recurrence, serum level of CA19-9 also remained less than 2.0 U/mL. Conclusion. In patients with extremely low CA19-9, who consist of 9.8% of colorectal carcinoma cases, postoperative sequential measurement of serum level of CA19-9 contributed neither to assessment of curability of surgical resection nor to detection of recurrence.
Highlights
For patients with colorectal carcinoma, assessment of curability of the surgery as well as that of recurrence is a very important issue
Detection of the recurrence after potentially curative surgery is an important issue in management of the patients with colorectal carcinoma [1,2,3,4,5,6]
SLea, which is recognized by CA19-9, is a carbohydrate chain which is expressed on tumor cells and is known to play a role in adhesion between tumor cells and endothelial cells [18]. sialyl Lewis a (sLea) is secreted into the serum and is used as a tumor marker for pancreatic, hepatobiliary, gynecological, and colorectal carcinoma [9, 23,24,25]
Summary
For patients with colorectal carcinoma, assessment of curability of the surgery as well as that of recurrence is a very important issue. The “best” program for detection of the recurrence and for the treatment failure is not yet determined, the combination of two modalities such as imaging studies and tumor markers is generally used. Among tumor markers used in the field of gastroenterology, carcinoembryonic antigen (CEA) has been recommended in several guidelines and widely used for postoperative follow up as well as for the assessment of efficacy of the treatment [7,8,9]. CA19-9 has been used as a tumor marker for colorectal carcinoma [10,11,12,13], usually accompanied with CEA [14,15,16,17]. Little is known about the serum level of CA19-9 in these patients with special regards to progression and recurrence of colorectal carcinoma. The aim of this study is to clarify the changes of serum level of CA19-9 in these patients and elucidate its clinical significance
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