Clinical Values of serum carcinoembryonic antigen (CEA), glycoprotein antigen (CA) 50, CA19-9, and CA72-4, and the soluble fragment of cytokeratin 19 (CYFRA21-1) in early screening and prognosis prediction of colon cancer
clinical values of serum tumor markers
Abstract
aim: To investigate the clinical values of serum tumor markers carcinoembryonic antigen (CEA), glycoprotein antigen (CA) 50, CA19-9, and CA72-4, and the soluble fragment of cytokeratin 19 (CYFRA21-1) in early screening and prognosis prediction of colon cancer.
Methods: 50 patients with colon cancer were enrolled into case group and 50 healthy people undergoing physical examination were enrolled into control group. The expressions of CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 in two groups were compared.
Results: It was demonstrated that the expressions of CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 among patients in case group were all superior to those among patients in control group (P<0.05), and the expressions of four tumor markers among patients in late group were remarkably superior to those among patients in early group (P<0.05). Postoperative expressions of CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 were notably inferior to preoperative expressions (P<0.05). However, the expressions were apparently higher before treatment when postoperative recurrence and metastasis occurred (P<0.05). The positive detection rates of the combined detection of CA50, CA19-9, CA72-4, and CYFRA21-1 for recurrence and metastasis were all markedly superior to those of single indicator detection (P<0.05).
Conclusion: Tumor markers CEA, CA50, CA19-9, CA72-4, and CYFRA21-1 showed indication significance for detecting positive detection rate, tumor staging, and recurrence and metastasis of colon cancer. The combined detection could improve the detection rate of colon cancer and was conducive to early screening of colon cancer and the determination of prognosis of colon cancer.
References
[2] Majdop S, Skornick Y, Avital S, Berkovich L. Phospholipase D activation mediates growth and migration of colon cancer cells interacting with cancer-associated fibroblasts. Cell Mol Biol (Noisy-le-grand), 2018;64(14):84-88.
[3] Wu Z, Lu Z, Li L, Ma M, Long F, Wu R, Huang L, Chou J, Yang K, Zhang Y, Li X, Hu G, Zhang Y, Lin C. Identification and validation of ferroptosis-related LncRNA signatures as a novel prognostic model for colon cancer. Front Immunol, 2022;12:783362.
[4] Guo JN, Chen D, Deng SH, Huang JR, Song JX, Li XY, Cui BB, Liu YL. Identification and quantification of immune infiltration landscape on therapy and prognosis in left- and right-sided colon cancer. Cancer Immunol Immunother, 2022;71(6):1313-1330.
[5] Zhang HC, Deng SH, Pi YN, Guo JN, Xi H, Shi X, Yang XF, Zhang BM, Xue WN, Cui BB, Liu YL. Identification and validation in a novel quantification system of ferroptosis patterns for the prediction of prognosis and immunotherapy response in left- and right-sided colon cancer. Front Immunol, 2022;13:855849.
[6] Yoshino T, Argilés G, Oki E, Martinelli E, Taniguchi H, Arnold D, Mishima S, Li Y, Smruti BK, Ahn JB, Faud I, Chee CE, Yeh KH, Lin PC, Chua C, Hasbullah HH, Lee MA, Sharma A, Sun Y, Curigliano G, Bando H, Lordick F, Yamanaka T, Tabernero J, Baba E, Cervantes A, Ohtsu A, Peters S, Ishioka C, Pentheroudakis G. Pan-Asian adapted ESMO clinical practice guidelines for the diagnosis treatment and follow-up of patients with localised colon cancer. Ann Oncol, 2021;32(12):1496-1510.
[7] Vogel JD, Felder SI, Bhama AR, Hawkins AT, Langenfeld SJ, Shaffer VO, Thorsen AJ, Weiser MR, Chang GJ, Lightner AL, Feingold DL, Paquette IM. The American society of colon and rectal surgeons clinical practice guidelines for the management of colon cancer. Dis Colon Rectum, 2022;65(2):148-177.
[8] Shi W, Men L, Pi X, Jiang T, Peng D, Huo S, Luo P, Wang M, Guo J, Jiang Y, Peng L, Lin L, Li S, Lv J. Shikonin suppresses colon cancer cell growth and exerts synergistic effects by regulating ADAM17 and the IL 6/STAT3 signaling pathway. Int J Oncol, 2021;59(6):99.
[9] Khan H, Alam W, Alsharif KF, Aschner M, Pervez S, Saso L. Alkaloids and colon cancer: molecular mechanisms and therapeutic implications for cell cycle arrest. Molecules, 2022;27(3):920.
[10] Mukherjee AG, Wanjari UR, Bradu P, Murali R, Kannampuzha S, Loganathan T, C GPD, Prakash BPA, Renu K, Dey A, Vellingiri B, Valsala Gopalakrishnan A. The crosstalk of the human microbiome in breast and colon cancer: a metabolomics analysis. Crit Rev Oncol Hematol, 2022;176:103757.
[11] Lwin TM, Turner MA, Amirfakhri S, Nishino H, Debie P, Cosman BC, Hoffman RM, Hernot S, Bouvet M. Rapid tumor-labeling kinetics with a site-specific near-infrared anti-CEA nanobody in a patient-derived orthotopic xenograft mouse model of colon cancer. J Surg Oncol, 2021;124(7):1121-1127.
[12] Chen T, Wang Y, Nan Z, Wu J, Li A, Zhang T, Qu X, Li C. Interaction between macrophage extracellular traps and colon cancer cells promotes colon cancer invasion and correlates with unfavorable prognosis. Front Immunol, 2021;12:779325.
[13] Morimoto Y, Takahashi H, Arita A, Itakura H, Fujii M, Sekido Y, Hata T, Fujino S, Ogino T, Miyoshi N, Uemura M, Matsuda C, Yamamoto H, Mizushima T, Doki Y, Eguchi H. High postoperative carcinoembryonic antigen as an indicator of high-risk stage II colon cancer. Oncol Lett, 2022;23(5):167.
[14] Pang X, Xu B, Lian J, Wang R, Wang X, Shao J, Tang S, Lu H. Real-world survival of colon cancer after radical surgery: a single-institutional retrospective analysis. Front Oncol, 2022;12:914076.
[15] Yu K, Qiang G, Peng S, Kuang R. Potential diagnostic value of the hematological parameters lymphocyte-monocyte ratio and hemoglobin-platelet ratio for detecting colon cancer. J Int Med Res, 2022;50(9):3000605221122742.
[16] Zhou H, Wang S, Cai Z, Qiu E, Chen Q, Rao X, Han S, Li Z. Adjuvant chemotherapy benefits on patients with elevated carcinoembryonic antigen in stage IIA colon cancer: a SEER-based analysis. Int J Colorectal Dis, 2022;37(12):2481-2489.
[17] Hao Z, Parasramka S, Chen Q, Jacob A, Huang B, Mullett T, Benson AB. Neoadjuvant versus adjuvant chemotherapy for resectable metastatic colon cancer in non-academic and academic programs. Oncologist, 2023;28(1):48-58.
[18] Liu Y, Zhang H, Zheng M, Wang C, Hu Z, Wang Y, Xiong H, Fan B, Wang Y, Hu H, Tang Q, Wang G. Nomogram to predict the occurrence and prognosis of distant metastasis in T1N0 colon cancer: a SEER data-based study. Int J Gen Med, 2021;14:9131-9143.
[19] Minnix M, Kujawski M, Poku E, Yazaki PJ, Wong JYC, Shively JE. Improved tumor responses with sequential targeted alpha followed by IL2 immunocytokine therapies in treatment of CEA positive breast and colon tumors in CEA transgenic mice. J Nucl Med, 2022;63(12):1859-1864.
[20] AbdelMageed M, Ismail HTH, Olsson L, Lindmark G, Hammarström ML, Hammarström S, Sitohy B. Clinical significance of stem cell biomarkers EpCAM, LGR5 and LGR4 mRNA levels in lymph nodes of colon cancer patients. Int J Mol Sci, 2021;23(1):403.
[21] Kasahara K, Enomoto M, Udo R, Tago T, Mazaki J, Ishizaki T, Yamada T, Nagakawa Y, Katsumata K, Tsuchida A. Prognostic value of preoperative high-sensitivity modified Glasgow prognostic score in advanced colon cancer: a retrospective observational study. BMC Cancer, 2022;22(1):20.
[22] Meng G, Yang S, Chen F. Survival for patients with metastatic colon cancer underwent cytoreductive colectomy in the era of rapid development of anticancer drugs: a real-world analysis based on updated population dataset of 2004-2018. Front Pharmacol, 2022;13:983092.
[23] Sawayama H, Miyamoto Y, Ogawa K, Ohuchi M, Tokunaga R, Yoshida N, Kobayashi H, Sugihara K, Baba H. Index of estimated benefit from lymph node dissection for stage I-III transverse colon cancer: an analysis of the JSCCR database. Langenbecks Arch Surg, 2022;407(5):2011-2019.
[24] Ishii K, Watanabe J, Goto K, Suwa Y, Nakagawa K, Suwa H, Ozawa M, Ishibe A, Kunisaki C, Endo I. The prognostic significance of apical lymph node metastasis in patients with high-risk stage III colon cancer. Sci Rep, 2022;12(1):2059.
[25] Weinberg BA, Winslow ER, Bayasi M, Krainock MR, Olshan PM, Billings PR, Aleshin A. Early detection of circulating tumor DNA postoperatively enables discovery of resectable metastatic disease in a patient with colon cancer. Case Rep Oncol, 2021;14(3):1748-1753.
[26] Wang Y, Zhou Y, Lin H, Chen H, Wang S. Paeoniflorin inhibits the proliferation and metastasis of ulcerative colitis-associated colon cancer by targeting EGFL7. J Oncol, 2022;2022:7498771.
[27] Murray NP, Villalon R, Hartmann D, Rodriguez PM, Aedo S. Improvement in the neutrophil-lymphocyte ratio after combined fluorouracil, leucovorina and oxaliplatino based (FOLFOX) chemotherapy for stage III colon cancer is associated with improved minimal residual disease and outcome. Asian Pac J Cancer Prev, 2022;23(2):591-599.
[28] Pedrazzani C, Turri G, Marrelli D, Kim HJ, Park EJ, Spolverato G, Foppa C, Spinelli A, Pucciarelli S, Baik SH, Choi GS. Prediction of metachronous peritoneal metastases after radical surgery for colon cancer: a scoring system obtained from an international multicenter cohort. Ann Surg Oncol, 2022;29(12):7896-7906.
[29] Riffet M, Eid Y, Faisant M, Fohlen A, Menahem B, Alves A, Dubois F, Levallet G, Bazille C. Deciphering promoter hypermethylation of genes encoding for RASSF/hippo pathway reveals the poor prognostic factor of RASSF2 gene silencing in colon cancers. Cancers (Basel), 2021;13(23):5957.
[30] Teijeira A, Migueliz I, Garasa S, Karanikas V, Luri C, Cirella A, Olivera I, Cañamero M, Alvarez M, Ochoa MC, Rouzaut A, Rodriguez-Ruiz ME, Sanmamed MF, Klein C, Umaña P, Ponz M, Bacac M, Melero I. Three-dimensional colon cancer organoids model the response to CEA-CD3 T-cell engagers. Theranostics, 2022;12(3):1373-1387.
[31] Fleming CA, Jordan P, O'Leary DP, Corrigan MA, Wang JH, Redmond HP. Perioperative cell-free DNA trends predict recurrence of non-metastatic colorectal cancer significantly earlier than CEA trends over the first 2 years post-operatively in stage II and stage III colon cancer. Int J Colorectal Dis, 2022;37(5):1119-1126.
[32] Ushigome M, Shimada H, Kaneko T, Miura Y, Nagashima Y, Suzuki T, Kagami S, Kurihara A, Funahashi K. Preoperative CRP(-)/CEA(-)/CA19-9(-)/non-T4 in stage III colorectal cancer is favorable risk for recurrence. J Anus Rectum Colon, 2022;6(4):264-273.
[33] Ogata S, Fujita F, Fujiyoshi K, Sudou T, Yoshida T, Koushi K, Murotani K, Yamauchi S, Sugihara K, Akagi Y. Prognostic value of preoperative carcinoembryonic antigen and carbohydrate antigen 19-9 levels for adjuvant chemotherapy in stage II colorectal cancer: a nationwide multicenter retrospective study. J Anus Rectum Colon, 2022;6(4):249-258.
[34] Wang H, Jin W, Wan C, Zhu C. Diagnostic value of combined detection of CA72-4, CA19-9, and carcinoembryonic antigen comparing to CA72-4 alone in gastric cancer: a systematic review and meta-analysis. Transl Cancer Res, 2022;11(4):848-856.
[35] Luo K, Zhao C, Luo Y, Pan C, Li J. Electrochemical sensor for the simultaneous detection of CA72-4 and CA19-9 tumor markers using dual recognition via glycosyl imprinting and lectin-specific binding for accurate diagnosis of gastric cancer. Biosens Bioelectron, 2022;216:114672.
Copyright (c) 2025 Yingqiang Zhang, Ze Song, Jun Tang, Min Wu, Zhi Li

This work is licensed under a Creative Commons Attribution 4.0 International License.
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
