Comparting study of cytokeratin 18 fragment M65 with CA19-9 and CEA as a biomarker in Iraqi colon cancer patients

Abstract

Author(s): Emad J. Kadhim*, Ghid H. Abdulhadi, Manwar alnaqqash and Khalid A. Alyodawi

Cytokeratin 18-M65 (CK18-M65), Carbohydrate Antigen 19-9 (CA 19-9), and Carcinoembryonic Antigen (CEA) in stage II, III, and IV colon cancer patients. The stages were classified according to TNM classification.

Methods: CK18-M65, CA19-9, and CEA were measured in serum samples of 27 patients who had stage II, 28 patients who had stage III, and 45 patients had stage IV colon cancer and 30 healthy subjects to show the correlation between the different stages and the change in the three markers.

Results: Plasma CK18-M65 levels were significantly high in all study stages of colon cancer patients but their mean ± SEM was higher in stage II than stages III and IV, while the mean ± SEM of plasma levels of both CA19-9 and CEA levels were significantly associated with tumor stage. The area under receiver operating characteristics curve (AUC) of CK18-M65, CA19-9, and CEA were (0.96, 0.7, and 0.8) in stage II, (0.88, 1, and 1) in stage III, and (0.89, 1, and 1) in stage IV. However, AUCs of CK18-M65 are higher in stage II than in stages III and IV. Moreover, the AUCs of CA19-9 and CEA were raised when the stage was raised and they were higher in the metastatic stage.

Conclusion: CK18-M65 exhibited the highest sensitivity for early stages than the advanced stage, contrariwise CA19-9 and CEA which were the highest sensitivity in advanced stages. This study suggests that CK18-M65 can be used as a tumor marker in screening examinations and detection for early stages of colon cancer and that can reduce mortality and morbidity of this cancer

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