Objective: To investigate the clinical diagnostic and prognostic value of preoperative serum tumor markers in patients with colorectal cancer (CRC).
Methods: From September 2013 to September 2016, we enrolled 980 patients diagnosed with CRC and 870 healthy subjects from The Affiliated Cancer Hospital of Shanxi Medical University. Patients were grouped and compared in accordance with tumor stage, tumor location, lymph node metastasis, distant metastasis, histological type, depth of invasion, growth type, and other factors. Serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and carbohydrate antigen 24-2 (CA24-2) concentrations in patient peripheral blood were measured, and the diagnostic value of the tumor markers in diagnosing CRC was assessed by receiver operating characteristic analysis.
Results: The sensitivity of serum tumor markers in combination was significantly higher than serum tumor markers detected individually. CA19-9 levels were significantly correlated with CA24-2 levels (r = 0.884; P < .001) in patients with CRC. The preoperative CEA, CA19-9, and CA24-2 levels in patients with colon cancer were significantly higher than in patients with rectum cancer (all P < .001). The CA19-9 and CA24-2 levels were significantly higher in patients with lymph node metastasis than without (both P < .001). In addition, the CEA, CA19-9, and CA24-2 levels in patients with distant metastasis were significantly higher than those in patients without metastasis (all P < .001). Stratified analysis showed that CEA, CA19-9, and CA24-2 levels were significantly correlated with TNM staging (P < .05). With regard to the depth of tumor invasion, CEA, CA19-9, and CA24-2 levels in tumors outside the serosa were significantly higher than those in other tumor types (P < .05). In terms of diagnostic performance, CEA had a sensitivity of 0.52 and a specificity of 0.98, CA19-9 had a sensitivity of 0.35 and a specificity of 0.91, and CA24-2 had a sensitivity of 0.46 and a specificity of 0.95.
Conclusion: The detection of serum tumor markers CEA, CA19-9, and CA24-2 is a good method for supporting diagnosis, making treatment decisions, judging therapeutic effect, and predicting prognosis when managing patients with CRC.