Abstract
Blood-based protein biomarkers have recently shown as simpler diagnostic modalities for colorectal cancer, while their association with clinical pathological characteristics is largely unknown. In this study, we not only examined the sensitivity and reliability of single/multiple serum markers for diagnosis, but also assessed their connection with pathological parameters from a total of 279 colorectal cancer patients. Our study shown that glycoprotein carcinoembryonic antigen (CEA) owns the highest sensitivity among single marker in the order of CEA > cancer antigen 72-4 (CA72-4) > cancer antigen 19-9 9 (CA19-9) > ferritin > cancer antigen 125 (CA125), while the most sensitive combined-markers for two to five were: CEA + CA72-4; CEA + CA72-4 + CA125; CEA + CA19-9 + CA72-4 + CA125; and CEA + CA19-9 + CA72-4 + CA125 + ferritin, respectively. We also demonstrated that patients who had positive preoperative serum CEA, CA19-9, or CA72-4 were more likely with lymph node invasion, positive CA125 were prone to have vascular invasion, and positive CEA or CA125 were correlated with perineural invasion. In addition, positive CA19-9, CA72-4, or CA125 was associated with poorly differentiated tumor, while CEA, CA19-9, CA72-4, CA125 levels were positively correlated with pathological tumor-node-metastasis stages. We here conclude that combined serum markers can be used to not only diagnose colorectal cancer, but also appraise the tumor status for guiding treatment, evaluation of curative effect, and prognosis of patients.
Highlights
We first analyzed the sensitivity of individual marker, e.g. carcinoembryonic antigen (CEA), cancer antigen 19-9 9 (CA19-9), cancer antigen 72-4 (CA72-4), cancer antigen 125 (CA125) and serum ferritin (SF)
Our study demonstrated that lymphatic metastasis, vascular invasion, nerve infiltration, tumor differentiation, as well as pathological tumor-node-metastasis (pTNM) stage, all can be the factor to influence the levels of tumor markers
We proposed that levels of CEA, CA19-9, CA72-4, and
Summary
We here present the analysis of the diagnostic sensitivity of single and combination of preoperative serum tumor markers, including CEA, CA125, CA19-9, CA72-4 and SF in CRC patients. Pathological parameters (i.e., lymph node metastasis, vascular invasion, etc.) with CEA, CA19-9, CA72-4, CA125 and SF (Table 2) as following: (1) Chi-square test results showed that the preoperative serum CEA expression was significantly different in the presence or absence of lymph node metastasis, nerve infiltration, or pathological tumor-node-metastasis (pTNM) staging (p < 0.05). There were significant statistical differences for preoperative serum CA19-9 expression in the presence or absence of lymph node metastasis, tumor differentiation, or pTNM staging (p < 0.05).
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