Tomašević Ratko, Milosavljević Tomica, Stojanović Dragoš, Gluvić Zoran, Dugalić Predrag, Ilić Ivan, Vidaković Radosav
Clinical Hospital Center Zemun, Belgrade, Clinic of Internal Medicine, University of Belgrade, School of Medicine.
Clinical Center of Serbia, Gastroenterology and Hepatology Clinic, University of Belgrade, School of Medicine.
J Med Biochem. 2016 Sep;35(3):324-332. doi: 10.1515/jomb-2016-0014. Epub 2016 Jul 6.
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.
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.
Age, gender, tumor localization, macro-morphological and histological characteristics did not influence biomarkers serum levels. Both were significantly higher (p<0.01) in patients with Dukes D stage of CRC compared with controls. Sensitivity (76.8%) and specificity (76.6%) of CEA alone were higher than for CA 19-9, but with no statistical significance. Furthermore, sensitivity of CEA alone in the Dukes A/B group was similar to the entire CRC patient group.
Although not recommended as a screening method for the general population, elevated values of each biomarker indicate further diagnostic procedures and their simultaneous testing can improve the diagnostic sensitivity in early detection of CRC, as shown by the united analysis (AUC 0.842).
结直肠癌（CRC）是包括塞尔维亚在内的全球重要的肿瘤学和公共卫生问题。不幸的是，一半的患者在疾病晚期才被确诊，因此，通过癌胚抗原（CEA）和糖类抗原19-9（CA 19-9）等特定肿瘤生物标志物进行早期检测是应对CRC扩散的唯一途径。
我们的横断面研究评估了CRC的一些临床、内镜和组织学特征对CEA和CA 19-9血清水平的影响，以确定这些生物标志物是否与CRC检测相关。该研究包括372名参与者：181名患有CRC，191名参与者为对照组。采用内镜和组织学检查诊断CRC，同时采用额外的超声和腹部计算机断层扫描成像对疾病进行分期。在确诊CRC后进行CEA和CA 19-9的测量。
年龄、性别、肿瘤定位、大体形态和组织学特征均不影响生物标志物的血清水平。与对照组相比，CRC Dukes D期患者的两者水平均显著更高（p<0.01）。单独CEA的敏感性（76.8%）和特异性（76.6%）高于CA 19-9，但无统计学意义。此外，单独CEA在Dukes A/B组中的敏感性与整个CRC患者组相似。
虽然不建议将其作为普通人群的筛查方法，但每个生物标志物的升高值都表明需要进一步的诊断程序，联合分析显示（曲线下面积为0.842），同时检测它们可以提高CRC早期检测的诊断敏感性。
