The Clinical Significance Of Combination Tests Of Serum Tumor Makers In Colorectal Cancer Patients

Objective:To screen optimal combination of tumor markers by single tests and combination tests of CEA, CA19-9. CA72-4, AFP and CA24-2in colorectal cancer patients at different stage and different time, and to explore its utility for diagnosis, evaluating curative effect, monitoring for recurrence and metastasis, and instructing clinical treatment.Methods:For this study, we considered161colorectal cancer patients at Shanxi Tumor Hospital between January2006and January2007, and150healthy controls. CEA, CA19-9, CA72-4and AFP were detected by electrochemiluminescence method; CA24-2was measured by the enzyme-linked immunosorbent assay (ELISA)method. All datas were analysed by SPSS13.0software. T tests or rank test was selected according to mean square equal or not.Chi-square test was applied for quantitative datas.Results:1. For age and gender, there was no statistical difference between two groups(p>0.05).2. The level of CEA, CA19-9and CA24-2at stage Ⅲ/Ⅳ was significantly higher than the stage Ⅰ/Ⅱpatients (p<0.05), but no difference of AFP、CA72-4were seen.(p>0.05).3、Serum levels of CEA、CA19-9、CA24-2、CA72-4at6months after therapy (surgical trestment+chemotherapy) decreased to nomal level of healthy controls.4、Serum levels of tumor markers in57patients increased to some extent at8months after therapy, only43of57cases were detected by diagonisic imaging. Remaining cases were detected by diagonisic imaging at12months after therapy. Therefore, changes of tumor markers were4months earlier than imaging. Serum levels of CEA、CA19-9、CA24-2、CA72-4at12months after therapy in patients with recurrence and metastasis significantly increased than without recurrence and metastasis(p<0.05), but no difference of AFP was observed((p>0.05)).5、Serum levels of tumor markers in92patients increased to some extent at19months after therapy, only66of92cases were detected by diagonisic imaging. Remaining cases were detected by diagonisic imaging at24months after therapy. Therefore, changes of tumor markers were5months earlier than imaging. Serum levels of tumor markers at24months after therapy in patients with recurrence and metastasis significantly increased than without recurrence and metastasis(p<0.01).6. The frequency of recurrence and metastasis in CEA, CA19-9andCA24-2positive patients was higher than negative cases. Time of recurrence and metastasis in positive cases was shorter than negative ones. And it indicated that there was a relationship between positivities of tumor markers and recurrence, metastasis.7. COX’s regession analysis reveales that clinical staging, CEA, CA19-9and CA24-2were important and independent factor for predicting recurrence and metastasis of colorectal cancer patients. Whereas, AFP and CA72-4were not served as independent factor.8.The sensitivity of combination tests of five tumor markers was82.1%, which was statistically better than that single tests(P<0.005).Conclusion:Serum levels of CEA, CA19-9, CA24-2and CA72-4in post-therapy patients with recurrence and metastasis were significantly higher than those without recurrence and metastasis. Moreover, the sensitivity of combination tests of CEA, CA19-9, CA24-2and CA72-4was higher than single tests. Changes of serum tumor markers levels was earlier than diagosic imaging. COX’s regession analysis reveales that clinical staging, CEA,CA19-9and CA24-2were important and independent factor for predicting recurrence and metastasis of colorectal cancer patients.