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Comparative Analysis of Predictive Biomarkers for Therapeutical Strategies in Colorectal Cancer

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Abstract

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.

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Acknowledgments

This work is supported by The Deutsche Bundesstiftung Umwelt (DBU, 16011). The authors thank Mrs. Ulrike Faber and Mrs. Helene Greb for their assistance in the preparation of this manuscript and Mrs. Andrea Trumpfheller, Mrs. Sabine Mueller, and Mrs. Mariola Dragan for their technical support.

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Authors and Affiliations

  1. Department of Surgery I, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany

    Martin Gasser MD, Marco Bueter MD, Andreas Thalheimer MD, Arnulf Thiede MD & Detlef Meyer MD

  2. Department of Surgery I, Molecular Oncology and Immunology, University of Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany

    Christiane Gerstlauer, Martin Grimm, Ekaterina Nichiporuk & Ana Maria Waaga-Gasser PhD

  3. American Red Cross, New England Region, Dedham, MA, 02026, USA

    Tatiana Lebedeva PhD

  4. Department of Nephrology, University of Munich, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany

    Jens Lutz MD & Uwe Heemann MD

  5. Interdisziplinäres Tumorzentrum, University of Wuerzburg, Josef-Schneiderstr. 2, 97080, Wuerzburg, Germany

    Uwe Maeder MD

  6. Instituto de Pesquisas Medicas, Faculdade Evangelica do Parana, Rua Padre Anchieta 2770, 80730000, Curitiba, Parana, Brasil

    Carmen Ribas MD & Claudia Ribas MD

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  1. Martin Gasser MD
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  2. Christiane Gerstlauer
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  15. Ana Maria Waaga-Gasser PhD
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Correspondence to Ana Maria Waaga-Gasser PhD.

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Martin Gasser and Christiane Gerstlauer are Co-first authors

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Gasser, M., Gerstlauer, C., Grimm, M. et al. Comparative Analysis of Predictive Biomarkers for Therapeutical Strategies in Colorectal Cancer. Ann Surg Oncol 14, 1272–1284 (2007). https://doi.org/10.1245/s10434-006-9155-0

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  • DOI: https://doi.org/10.1245/s10434-006-9155-0

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