The Evaluation of Diagnostic Value of the Tumor Markers: CCSA-2 and CEA in Colorectal Cancer
Finding the biomarker or biomarkers with high sensitivity and specificity in colorectal cancer, and thus a high diagnostic value will determine their clinical usefulness in clinical practice. An effective noninvasive blood test would be an ideal method to detect colorectal cancer. Discovered in 2007 a novel tumor marker CCSA-2 showes a promising results in patients with colorectal cancer.The aim of the study was the evaluation of diagnostic and clinical value of a novel marker - colon cancer specific antigen-2 (CCSA-2) in colorectal adenocarcinoma in comparison to carcinoembryonic antigen (CEA) in patients operated during the years 2008 to 2010 at Wrocław Medical University 1st Department and Clinic of General, Gastroenterological and Endocrinologic Surgery.Material and methods. The study was performed on 40 patients with colorectal cancer and 40 patients in control group consisted of healthy subjects who had colonoscopy examinations with negative results (no pathology in the colon was found). The obtained results were statistically analyzed using nonparametric tests - Mann Whitney U and Kruskal-Wallis and Spearman's rank correlation coefficients. To determine the clinical value of CCSA-2 and CEA in those groups, their sensitivity and specifity was evaluated using ROC analysis. This analysis determines the accuracy and diagnostic value of both tests.Results. There was a positive correlation between markers in patients with colorectal cancer and a statistically significant relationship according to which respondents with higher concentrations of CCSA-2 also have higher concentrations of CEA (R=0.754, p<0,001). Concentrations of tumor markers increase and correlate with the clinical progression of the disease. Accuracy of CCSA-2 test using ROC analysis showed a slightly lower measurement of antigen CCSA-2 as diagnostic value in colorectal cancer in comparison to measurement of antigen CEA (accuracy of tests: CCSA-2 - 52%, CEA - 60%).Conclusions. CCSA-2 as a single tumor marker has a low diagnostic value in colorectal cancer because of low sensitivity and specifity. The diagnostic value of novel marker is slightly lower than previously understood and accepted in clinical practice - CEA.
- Steward BW, Kleihues P: World cancer report. IARC Press, Lyon, France 2003: 198.
- Al-Mulla F, Behbehani AI, Bitar MS et al.: Genetic profiling of stage I and II colorectal cancer may predict metastatic relapse. Mod Pathol 2006; 19: 648-58.
- Wojciechowska U, Didkowska J, Zatoński W: Nowotwory złośliwe w Polsce w 2006 roku. Centrum Onkologii - Instytut, Warszawa 2006.
- Spann SJ, Rozen P, Young GP et al.: Colorectal cancer: how big is the problem, why prevent it, and how might it present? In: Rozen P, Young GP, Levin B, Spann SJ, editors. Colorectal Cancer in Clinical Practice. London: Martin Dunitz Ltd 2002: 1-18.
- Eriksen MT, Wibe A, Haffner J et al.: Prognostic group in 1,676 patients with T3 rectal treated without preoperative radiotherapy. Dis Colon Rectum 2007; 50: 156-67.[WoS]
- Bębenek M, Pudełko M, Cisarz K et al.: Therapeutic results in low-rectal cancer patients treated with abdominosacral resection are similar to those obtained by means of anterior resection in mid- and upper-rectal cancer cases. Eur J Surg Oncol 2007; 33: 320-23.[PubMed]
- Duffy MJ, van Dalen A, Haglund C et al: Tumor markers in colorectal cancers: European Group on Tumour Markers (EGTM) guidelines for clinical use. Eur J Cancer 2007; 43: 1348-60.
- Compton C, Fenoglio-Preiser CM, Pettigrew N et al.: American Joint Committee on Cancer Prognostic Factors Consensus Conference: Colorectal Cancer Working Group. Cancer 2000; 88: 1739-57.
- Konety BR, Getzenberg RH: Nuclear structural proteins as biomarkers of cancer. J Cell Biochem 1999; Suppl 32-33: 183-91.[PubMed][Crossref]
- Leman ES, Getzenberg RH: Nuclear structure as a source of cancer specific biomarkers. J Cell Biochem 2008; 104(6): 1988-93.[PubMed][WoS]
- Brunagel G, Schoen RE, Getzenberg RH: Colon cancer specific nuclear matrix protein alterations in human colonic adenomatous polyps. J Cell Biochem 2004; 91: 365-74.[PubMed]
- Miller TE, Beausang LA, Winchell LF et al.: Detection of nuclear matrix proteins in serum from cancer patients. Cancer Res 1992; 52: 422-27.
- Leman ES, Schoen RE, Magheli A et al.: Evaluation of colon cancer - specific antigen 2 as a potential serum marker for colorectal cancer. Clin Cancer Res 2008; 14(5): 1349-54.
- Walgenbach-Brunagel G, Burger B, Leman ES et al.: The use of colon cancer associated nuclear antigen CCSA-2 for the blood based detection of colon cancer. J Cell Biochem 2008; 104: 286-94.[WoS]
- Goslin R, O'Brien MJ, Steele G et al.: Correlation of plasma CEA and CEA tissue staining in poorly differentiated colorectal cancer. Am J Med 1981; 71: 246-53.
- Von Kleist S, Hesse Y, Kananeeh H: Comparative evaluation of 4 tumor markers, CA 242, CA 19/9, TPA and CEA in carcinomas of the colon. Anticancer Res 1996; 16: 2325-31.