Magic™ Anti-CA 19-9 monoclonal antibody, clone N23260

Introduction: As one of the most common causes of cancer deaths in Poland, colorectal cancer, remains a mystery when factors affecting local and distant lymph node metastasis are concerned. Aim: In this study the authors have analysed possible correlations between the number of regional (and distant) lymph nodes affected by cancer, location and stage of the primary tumour, levels of oncological markers CA19-9 and CEA, and the patients age, sex, body mass index (BMI), and other clinical symptoms. Material and methods: A special questionnaire was created for this study, and a group of 100 men and women was selected. All patients in the study group had undergone surgery due to colorectal cancer. Results: There were no statistically significant relationships between age, and number and location of metastases (p > 0.05). Primary tumour assessment did not show a statistically significant relationship with the presence of metastases to regional lymph nodes (p > 0.05). There was also no statistically significant correlation between tumour localisation and lymph node metastases (p > 0.05) or between tumour size, BMI, occurrence of physical symptoms, and involvement of distant lymph nodes (p > 0.05). The highest CEA was observed in a patient with nine regional lymph node metastases (612.46 ng/ml) and the lowest in one with metastases to two regional nodes (0.2 U/ml). CEA value above 5 ng/ml was found in 35.74% of patients with regional lymph node metastases. A statistically significant relationship was reported (p < 0.05). Conclusions: The location of the primary tumour, and its pathological stage and size does not seem to have a direct correlation with the occurrence of regional lymph node metastases. Metastasis to distant lymph nodes seems to be a consequence of metastases in regional nodes. Elevated CEA tumour marker values are significantly related to metastases in regional lymph nodes. The elevation of CA 19-9 and CEA tumour markers significantly correlates with the presence of metastasis to distant lymph nodes. The location of the primary tumour determines the formation of metastases in distant lymph nodes.

The present study investigated the value of combinations of five specific tumor biomarkers for the diagnosis of colorectal cancer (CRC): Neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), cancer antigen (CA)19-9, CA125 and CA242. Associations between these markers and clinicopathological characteristics (including the Tumor-Node-Metastasis stage) were also assessed. Serum levels of the 5 markers were compared between 358 patients with CRC and 298 healthy individuals (CRC and control group, respectively). The NSE concentration of the CRC group was significantly higher compared with the control. Furthermore, patients at clinical stage III+IV exhibited significantly higher NSE levels compared with those at stage I+II. The serum NSE level of N(+)patients was significantly higher compared with the N(-)group, and the NSE level of M(1)patients was significantly compared with the M(0)group. NSE level was also significantly associated with tumor stage, lymph node metastasis, distant metastasis and hematochezia. The area under the receiver operating characteristic curve (AUC) for NSE in CRC was 0.766, which was significantly higher than that of the other four markers, which ranged from 0.560-0.682. The AUC of NSE, CEA, CA19-9, CA125, CA242 combined was significantly higher compared with any of the markers individually (range, 0.796-0.858). Therefore, serum NSE may be a good clinical tool for the auxiliary diagnosis of colorectal cancer. Besides, the combination of NSE, CEA, CA19-9, CA125 and CA242 was significantly more sensitive compared with NSE alone. Thus, the combined detection of the 5 tumor markers may be more useful for the diagnosis of CRC.