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Clinical Significance of CA19-9 in the Follow-Up of Colorectal Cancer Patients with Elevated Preoperative Serum CA19-9.
MedLine Citation:
PMID:  23321120     Owner:  NLM     Status:  Publisher    
Background/Aims: We hypothesized an advantage of using carbohydrate antigen 19-9 (CA19-9) over carcinoembryonic antigen (CEA) in postoperative surveillance of colorectal cancer (CRC) patients with elevated preoperative serum CA19-9 (PreCA19-9). Methodology: We analyzed 197 CRC patients with elevated PreCA19-9 (>=37U/mL). Serum levels of CEA and CA19-9 were monitored postoperatively, according to standard protocol. IndexCEA and IndexCA19-9 were defined as the levels of CEA and CA19-9, respectively, recorded at recurrence confirmation or at the last follow-up of non-recurrence. Results: There were 56 recurrences during follow-up. IndexCA19-9 (cut-off, 38.6U/mL) had better sensitivity (0.80 vs. 0.68) and specificity (0.87 vs. 0.83) than did IndexCEA (cut-off. 2.8ng/mL). Area under the curve (AUC) analysis revealed that although IndexCA19-9 (0.90; 95% confidence interval [CI], 0.84-0.95) had better coverage than IndexCEA (0.84; 95% CI, 0.78-0.90), there was no significant difference (p=0.085). With the progressive rising of PreCA19-9 levels, we observed the trend of better AUC performance of IndexCA19-9 over IndexCEA. At a cut-off of 42U/mL for PreCA19-9, IndexCA19-9 began to have significantly better coverage than IndexCEA (p=0.027). Conclusion: The surveillance advantage of CA19-9 over CEA was shown in the group of patients with preoperative CA19-9 levels >42U/mL.
Shung-Haur Yang; Jeng-Kai Jiang; Shih-Ching Chang; Chi-Jung Juang; Jen-Kou Lin
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-16
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  60     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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