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10.1245/s10434-006-9155-0
Annals of Surgical Oncology 14:1272-1284 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Comparative Analysis of Predictive Biomarkers for Therapeutical Strategies in Colorectal Cancer

Martin Gasser, MD1, Christiane Gerstlauer2, Martin Grimm2, Marco Bueter, MD1, Tatiana Lebedeva, PhD3, Jens Lutz, MD4, Uwe Maeder, MD5, Carmen Ribas, MD6, Claudia Ribas, MD6, Ekaterina Nichiporuk2, Andreas Thalheimer, MD1, Uwe Heemann, MD4, Arnulf Thiede, MD1, Detlef Meyer, MD1 and Ana Maria Waaga-Gasser, PhD2

1 Department of Surgery I, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
2 Department of Surgery I, Molecular Oncology and Immunology, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
3 American Red Cross, New England Region, Dedham, MA 02026, USA
4 Department of Nephrology, University of Munich, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany
5 Interdisziplinäres Tumorzentrum, University of Wuerzburg, Josef-Schneiderstr. 2, 97080, Wuerzburg, Germany
6 Instituto de Pesquisas Medicas, Faculdade Evangelica do Parana, Rua Padre Anchieta 2770, 80730000 CuritibaParana, Brasil

Correspondence: Address correspondence and reprint requests to: Ana Maria Waaga-Gasser, PhD; E-mail: waaga-gasser{at}chirurgie.uni-wuerzburg.de

Background: Prognostic information regarding the risk of postoperative tumor recurrence defined by a profile of serological, morphological and/or molecular markers can have potential value, particularly for patients with colorectal carcinoma (CRC) of the International Union Against Cancer (UICC) stage II/III who may benefit from adjuvant chemotherapy after surgery.

Methods: A retrospective study of 783 patients with CRC (UICC I–III) including a subgroup analysis of 116 subjects was conducted to determine preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and p53 serum levels. In addition, protein and gene expression of p53, CEA, and adenomatous polyposis coli (APC) was assessed in the tumors of those patients. The values of all serological, morphological, and molecular parameters were correlated with clinicopathological characteristics for their predictive value of tumor recurrence over a mean follow-up period of 32 ± 6.2 months.

Results: Serum CEA but not CA 19-9 or p53 was a significant prognostic factor for disease-free survival, along with UICC and T/N stage. When comparing elevated CEA, CA 19-9, and p53 serum levels with expression of the markers in the tumors, their overall expression was found to be 61.3% in the serum versus 93.5% in the tumor in analyzed patients (n = 116). In particular, all patients in UICC stages I–III who demonstrated at least three elevated markers (CEA/CA 19-9/p53) in serum and/or in the tumor presented with tumor recurrence/metastases.

Conclusion: Overall increased p53, CEA, and CA 19-9 serum levels and their marker expression in the tumor may be used at the time of primary tumor removal for defining patients at risk for tumor recurrence.

Key Words: Prognostic marker • Colorectal carcinoma • p53 • CEA • CA 19-9






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