Original Research Article Background: Carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) have been well recognized as tumor markers for colorectal cancer. Previous studies suggested that body mass index is inversely associated with the screening of CEA and CA19-9 levels and may reduce screening sensitivity. Objective: To assess the relation between CEA & CA 19-9 level and body mass index in colorectal carcinoma. Methods: A Prospective Observational Study was carried out at Department of Surgery, Dhaka Medical College Hospital (DMCH) from January, 2016 to December, 2016 (12 months). Cases were purposively selected according to inclusion criteria. Patients are divided group of on the basis of values of CEA level < 7 ng/dl and ≥ 7 ng/ml, CA 19-9 <37 ng/ml and ≥37 ng/ml. Body mass index divided three groups which are <18.5, 18.5-24.0 and >24 kg/m 2 . The quantitative observations were indicated by frequencies and percentages. P values <0.05 were considered as statistically significant. Results: Total 50 cases majority patients belonged to age 41-50 years in both groups (CEA <7 ng/ml and ≥7 ng/ml). The mean age was found 42.5±11.3 years in CEA (<7 ng/ml) group and 40.7±12.1 years in CEA (≥7 ng/ml) group. Male was found 15 (40.5%) in CEA (<7 ng/ml) group and 06 (46.2%) in CEA (≥7 ng/ml) group. Regarding histological type of the patients that tubular adenocarcinoma was 27 (73.0%) in CEA (<7 ng/ml) group and 10 (76.9%) in CEA (≥7 ng/ml) group. Majority patients had tumor size ≤5 cm in both groups, which was 23 (62.2%) in CEA (<7 ng/ml) group and 07 (53.8%) in CEA (≥7 ng/ml) group. Colon tumor was 16 (43.2%) in CEA (<7 ng/ml) group and 07 (53.8%) in CEA (≥7 ng/ml) group. Peritoneal metastasis was 04 (2.7%) in CEA (<7 ng/ml) group and 03 (23.1%) in CEA (≥7 ng/ml) group. Liver metastasis was 02 (5.4%) in CEA (<7 ng/ml) group and 02 (15.4%) in CEA (≥7 ng/ml) group. Regarding TNM staging of the patients CEA (<7 ng/ml) group majority 19 (51.4%) patients had TNM stage II and CEA (≥7 ng/ml) group 07 (53.8%) patients had TNM stage III. Majority patients had moderate histological differentiation in both groups, which was 31 (83.8%) in CEA (<7 ng/ml) group and 10 (76.9%) in CEA (≥7 ng/ml) group. Mean age was found 43.7±10.5 years in CA 19-9 (<37 ng/ml) group and 41.9±11.1 years in CA 19-9 (≥37 ng/ml) group. Colon tumor was 17 (42.5%) in CA 19-9 (<37 ng/ml) group and 06 (60.0%) in CA 19-9 (≥37 ng/ml) group. Peritoneal metastasis was 02 (5.0%) in CA 19-9 (<37 ng/ml) group and 02 (20.0%) in CA 19-9 (≥37 ng/ml) group. Liver metastasis was 03 (7.5%) in CA 19-9 (<37 ng/ml) group and 01 (10.0%) in CA 19-9 (≥37 ng/ml) group. CA 19-9 (<37 ng/ml) group majority 19 (47.5%) patients had TNM stage II and CA 19-9 (≥37 ng/ml) group 06 (60.0%) patients had TNM stage III. Almost two third (62.5%) patients was found tubular adenocarcinoma in CA 19-9 (<37 ng/ml) group and 03 (30.0%) in CA 19-9 (≥37 ng/ml) group. Majority patients had moderate histological differentiation in both groups, which was 32 (80.0%) in CA 19-9 (<37 ng/ml) group and 09 (90.0%) in CA 19-9 (≥37 ng/ml) group. More than three fourth (78.0%) patients had 18.5-24.0 kg/m 2 , 9 (18.0%) had >24.0 kg/m 2 and 2 (4.0%) had <18.5 kg/m 2 . Cut-off values and prognostic significance of CEA and CA19-9. A higher BMI was shown to be significantly associated with higher plasma volumes. Compared with the normal weight patients, the patients with BMI ≥24 had 10-15% higher plasma volumes. The association of BMI with CEA and CA19-9 mass was then investigated. The CEA and CA19-9 mass did not change significantly with increasing BMI, except for CEA in stage. The proportion of patients with overall abnormal CEA and CA19-9 levels at each cut-off value was decreased with BMI. CEA evaluation for colorectal cancer, true positive 3 cases, false positive 10 cases, false negative 8 cases and true negative 29 cases in identification by BMI. Sensitivity of BMI vs CEA was 27.3%, specificity 74.4%, accuracy 64.0%, positive and negative predictive values were 23.1% and 78.4% respectively. Sensitivity of BMI vs CA 19-9 was 27.3%, specificity 82.1%, accuracy 70.0%, positive and negative predictive values were 30.0% and 80.0% respectively. Negative correlation (r= -0.230; p=0.108) between BMI and CEA of colorectal cancer. Conclusion: Inverse correlation was found between body mass index with CEA and CA -19-9 in colorectal cancer patient, but sensitivity and specificity was low. The combination of preoperative CEA and CA19-9 levels was useful for predicting prognosis in patients with colorectal cancer.

/pdf/association-between-carcinoembryonic-antigen-carbohydrate-2igl3ecwgh.pdf

Association between Carcinoembryonic Antigen, Carbohydrate Antigen 19-9 and Body Mass Index in Colorectal Cancer Patients

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Association between Carcinoembryonic Antigen, Carbohydrate Antigen 19-9 and Body Mass Index in Colorectal Cancer Patients