Survival of patients with colorectal carcinoma - Possible prognostic valueof tissular carbohydrate antigen 19.9 determination

BACKGROUND. An important goal of serum tumor marker research is to provide a test for detecting cancer in early stages. Expression of carbohydrate ant igen (CA) 19.9 has been described in various malignancies. METHODS. The possible prognostic value measuring cytosol CA 19.9 expression in tumors was evaluated in:a study of 63 colorectal carcinoma (CRC) patien ts who were followed for at least 2 years. CA 19.9 expression in cytosol wa s determined by enzyme-linked immunoadsorbant assay, and measurement of thi s protein achieved by quantitative assay. RESULTS. Mean levels of cytosol CA 19.9 found in tumor samples were signifi cantly higher than those in nontumoral areas in CRC patients (P < 0.0005). Patients with more than 3 positive lymph nodes had a higher expression of t he marker (P < 0.05). Univariate and multivariate analyses revealed that cy tosol CA 19.9 concentration was an independent prognostic variable for rela pse. Furthermore, the probability of relapse increased 4.2 times for every increase in cytosol tumor marker of 5000 U/mg, and tumors located in the re ctum had a probability of relapse 9.5 times greater. CONCLUSIONS. Cystol CA 19.9 expression in CRC can be an independent prognos tic factor for relapse. Patients with high levels of CA 19.9 have worse pro gnosis than those with lower values. Therefore, this group of patients shou ld receive special management with regard to their follow-up and treatment. Moreover, quantitative cytosol tumor marker measurement is an easy and hig hly effective method for determining the prognoses of CRC patients. (C) 199 9 American Cancer Society.