As serum tumor markers CEA and CO 19- 9 in the prognosis and follow-up of colorectal cancer

ObjectiveTumor markers commonly used to diagnose and monitor colon cancer. However, its a common acceptance that tumor markers are limited in diagnosing diseases. Studies in this field are insufficient. The aim of this study is to investigate this issue.Material MethodsIn this study, 67 patients who admitted to Department of Gastroenterology, Adnan Menderes University Faculty of Medicine between 2005 and 2010 and diagnosed colon cancer according to colonoscopy and biopsy results were included in this study. 100 patients who admitted same department and were diagnosed IBS according to Rome III criteria with normal colonoscopy were selected in this study as control group.In both groups, patients were compared in terms of age, gender, family history of colon cancer and stomach cancer, smoking, alcohol consumption and level of CEA and Ca-19-9. In addition, CEA and Ca-19-9 levels in colon cancer group were obtained at the time of diagnosis, postop month one and end of year one, respectively.ResultsMean age of study group was 60 (39-82). The patient population consisted of 30 female (%44.77) and 37 male (%55.33). Mean age of control group was 50 (31-70) and there were 49 female (%49) and 51 male (%51).At the time diagnosis, %31.3 of patients with colon cancer were detected with high value of CEA and %14.9 were detected with high value of Ca-19-9.In control group, both CEA and Ca-19-9 were detected high value in % 4 patients. In patient group, there were statistically significant increase in CEA levels. Although there was significant difference between groups in term of their Ca-19-9 values, no statistically significant differences were found (p > 0.05). However, in colon cancer group, while all of patients with high level of CEA had three fold higher CEA levels than normal, in control group %100 of patients with high CEA level had CEA levels below three fold of normal.By Dukes Classification, in stage A %22, in stage D %57.1 of patients with colon cancer were determined with high value CEA. Additionally, %2.77 of patients in stage A and %42 of patients in stage D were stated high value of Ca-19-9.There were significant differences between time of diagnosis and post-op year 1 in terms of CEA and Ca-19-9 levels (p < 0.05).ConclusionsSignificant majority of colon cancer patients are stated with high value of CEA at the time of diagnosis. However, its possible to find CEA levels slightly high in patients without cancer, therefore if this values are found more than three fold of normal, the increase become significant. In advanced stage colon cancer (Stage D), both values of CEA and Ca-19-9 are rising progressively. Therefore, although tumor markers have limited value at the time of diagnosis, we believe that these markers can be useful examination for especially detecting stage of disease, determining progression and early diagnosing of relapses.Key Words: Colon Cancers, Tumor Markers, IBS