Study on correlation between CA 19-9 and colorectal carcinoma with normal or near normal CEA and its impact on patient survival

Colorectal carcinoma is the third most common cause of cancer related death worldwide after prostate cancer and lung cancer in males and breast cancer and lung cancer in females. Serum tumor markers including CEA and CA 19-9 are commonly used to predict prognosis in colorectal cancer patients. The American Society of Clinical Oncology (ASCO) guidelines for the use of tumor markers in CRC have recommended CEA measurement for preoperative follow up. However, in routine practice checking the level of CA 19-9 as a marker of colon cancer is not recommended for screening, diagnosis, staging or monitoring colorectal cancer. CA 19-9 was described by Koprowski et al. in 1979 as a monoclonal antibody against a human colorectal cancer cell line. It promotes adhesion of cancer cells to endothelial cells and plays a role in tumor progression in colorectal cancer patients. Several studies have demonstrated the usefulness of CA 19-9 as an indicator of prognosis and recurrence.In view of rising trend of the incidence of colorectal carcinoma in the Indian population this study was taken up to investigate the correlation between CA 19-9 with colorectal carcinoma of Indian origin. Since serum tumor marker assay is an easily applicable and relatively fast and cheap procedure, we investigated the relationship between elevated CA 19-9 level in colorectal carcinoma and evaluated the possible alterations in the level of this biomarker and associated our results with other classical clinicopathologic parameters.

Therefore, in the present study, we sought to investigate the usefulness of preoperative serum CA 19-9 level as a prognostic factor in a large cohort of colorectal cancer patients at a tertiary hospital.