Yonsei Med J.  2017 Sep;58(5):918-924. 10.3349/ymj.2017.58.5.918.

Serum CEA and CA 19-9 Levels are Associated with the Presence and Severity of Colorectal Neoplasia

• Kim NH
• Lee MY
• Park JH
• Park DI
• Sohn CI
• Choi K
• Jung YS

• KMID: 2418926
• DOI: http://doi.org/10.3349/ymj.2017.58.5.918

Abstract

PURPOSE
Limited data are available regarding the association between circulating serum carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA 19-9) concentrations and colorectal adenoma. We aimed to investigate whether elevated serum CEA and CA 19-9 levels are correlated with the presence of colorectal neoplasia (CRN) and whether the levels of these antigens vary according to CRN severity.
MATERIALS AND METHODS
A cross-sectional study was performed on asymptomatic subjects who underwent colonoscopy between 2010 and 2014 as part of a comprehensive health screening program in Korea.
RESULTS
A total of 124509 participants with measured serum CEA levels and 115833 participants with measured serum CA 19-9 levels were analyzed. Elevated CEA concentrations were associated with a higher rate of any adenoma, advanced adenoma, high-risk adenoma, advanced CRN (ACRN), overall CRN, and colorectal cancer (CRC). Elevated CA 19-9 concentrations were also associated with a higher rate of advanced adenoma, high-risk adenoma, ACRN, and CRC. Both elevated levels of CEA and CA 19-9 were identified as independent predictors of ACRN. Among patients with CRN, the proportions of elevated CEA/CA 19-9 levels were significantly higher in patients with ACRN than in those with non-ACRN, and these levels were correlated with larger lesion size and multiplicity of adenomas.
CONCLUSION
Both elevated serum CEA and CA 19-9 levels were associated with the presence of ACRN, as well as CRC. Elevated CEA levels were also associated with the presence of overall CRN. Moreover, both CEA and CA 19-9 levels were correlated with the severity of CRN.

Keyword

CEA; CA 19-9; colorectal neoplasia

MeSH Terms

Adult
CA-19-9 Antigen/*blood
Carcinoembryonic Antigen/*blood
Colonoscopy
Colorectal Neoplasms/*blood/*pathology
Cross-Sectional Studies
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Republic of Korea
Risk Factors
*Severity of Illness Index
CA-19-9 Antigen
Carcinoembryonic Antigen

Figure

• 

  Fig. 1 Flow diagram illustrating the selection of study subjects. CEA, carcinoembryonic antigen; CA 19-9, carbohydrate antigen 19-9.

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