Study of carcinoma embryonic antigen and carbohydrate antigen 19-9 levels in patients of esophageal cancer

Abstract

Background: The aim of the study was to analyze the role of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) as diagnostic and prognostic markers in patients of esophageal cancer. Various tumor markers are being investigated as non-invasive diagnostic and prognostic tools in patients of esophageal cancer.Methods: This was a prospective observational study in which we analyzed the levels of CEA and CA 19-9 in blood samples of 35 patients of esophageal cancer. All patients underwent esophagoscopy and computed tomographic (CT) scan to assess site and extent of tumor. Histological diagnosis was confirmed in all cases by endoscopy guided biopsy.Results: The sensitivity of CEA and CA 19-9 in detecting disease was found to be 34.3% and 28.6% respectively. The difference in CEA levels between squamous cell carcinoma and adenocarcinoma of esophagus was not found to be significant (p value=0.69). However, the difference in levels of CA 19-9 was found to be statistically significant (p value=0.02) between the two groups. The sensitivity and specificity of CEA to predict severity of disease was 66.7% and 70% respectively with positive and negative predictive value of 62.5% and 73.4 % respectively. In case of CA 19-9, sensitivity, specificity, positive and negative predictive values were 26.7%, 55%, 30.8% and 50% respectively.Conclusions: CEA was found to be a more sensitive diagnostic marker than CA 19-9 and better at predicting prognosis. However sensitivity and specificity of both were relatively low. CA 19-9 levels were seen to be higher in esophageal squamous cell carcinoma versus adenocarcinoma.