Abstract

Nai-Lu Lin64614, Shih-Ching Chang64615, Jeng-Kae Jiang64616 and Shung-Haur Yang64617*

Objective: The present study aimed to analyze the association between tumor makers and Peritoneal Dissemination (PD) detection in patients with Colorectal Cancer (CRC).

Background: The eighth edition of the American Joint Committee on Cancer (AJCC) staging system expanded the classification of the M category with the addition of M1c for PD due to its worse prognosis compared to other visceral organ metastases. The lack of specific symptoms and varying sensitivities of imaging studies leads to difficulty in PD detection.

Methods: A total of 1,109 patients with CRC who underwent tumor resection between June 2000 and December 2017 were included in this retrospective study. Serum tumor markers, including Carcinoembryonic Antigen (CEA), Carbohydrate Antigen 19-9 (CA19-9), and CA125, were analyzed preoperatively. The grading of PD was performed based on the findings during surgical exploration and further confirmed by pathology.

Results: CA125 had the lowest sensitivity; however, it showed the highest specificity and diagnostic accuracy compared to CEA and CA19-9. Based on the analysis of tumor marker levels in advancing stages, the levels of CA125 did not rise until stage IVC. CEA and CA19-9 levels increased significantly at stage IV; however, it was not possible to differentiate between stage IVC and other organ metastases.

Conclusion: Among the three tumor markers, CA125 levels were closely correlated with PD compared to CEA and CA19-9 levels. The present analysis of tumor markers poses a better chance of diagnosis of stage IVC preoperatively.