Published in Cancer Detection and Prevention 2001; 25(4):344-351.

Carcinoembryonic Antigen and CA19-9: Implications of Quantitative Marker Measurement in Tissues for Prognosis of Colorectal Cancer

Gerhard Gebauer, MD,a,b and Wolfgang Muller-Ruchholtz, MD, PhDc

aDepartment of Molecular and Cell Biology, Sidney Kimmel Cancer Center, San Diego, CA, bDepartment of Gynecology and Obstetrics, University of Erlangen-Nuremberg, Erlangen, Germany and cDepartment of Immunology, University of Kiel, Kiel, Germany

Address all correspondence and reprint requests to: Gerhard Gebauer, MD, Department of Molecular and Cell Biology, Sidney Kimmel Cancer Center, 10835 Altman Row, San Diego, CA 92121-1123.

ABSTRACT: Measurement of tumor markers in serum of colorectal cancer patients after surgery is a sensitive method in early diagnosis of systemic spread of tumor cells. Moreover, prognostic association of carcinoembryonic antigen (CEA) content in serum at the time of surgery is well known. However, fairly unclear is whether quantitative content of CEA and CA 19-9 in cancer tissue and adjacent normal mucosa of colorectal cancer patients is correlated to prognosis. Concentrations of CEA and CA 19-9 were analyzed simultaneously in serum, cancer tissue, and normal colonic mucosa of 41 colorectal cancer patients operated for cure. Follow-up data were available for up to 82 months (median, 47 months) after surgery. During the follow-up period, 20 patients had a tumor recurrence, and all these patients died of metastatic disease. Using the median concentration of CEA and CAI9-9 in tissues as a cut-off, no difference in overall and disease-free survival was observed between patients with elevated or normal CEA or CA 19-9 concentrations in tumor tissue. However, in adjacent histologically normal mucosa, elevated CEA content was associated with significantly shorter overall survival (P = .0385) and disease-free survival (P = .0141) but not CAI9-9 content. Despite the unknown biological function of tumor markers in malignant disease, measurement of tumor-associated antigens in colorectal tissues can become an interesting prognostic marker.

KEY WORDS: carcinoembryonic antigen, colonic mucosa, colorectal cancer prognosis, tumor marker.