Níveis séricos e imunoexpressão tecidual do marcador CA 19-9 no carcinoma colorretal e comprometimento linfonodal
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Resumo
Introdução: O carcinoma colorretal é uma das neoplasias mais incidentes nos países ocidentais. É controverso se os níveis séricos e a imunoexpressão tecidual do marcador tumoral CA 19-9 estão relacionados com o comprometimento linfonodal e com a invasão linfática no carcinoma colorretal. Casuística e métodos: Em 45 pacientes com carcinoma colorretal operados, o nível de CA19-9 pré-operatório e a imunoexpressão do CA19-9 no tecido neoplásico foram analisados. Valores de CA19-9 ≥ 37 UI/ml foram considerados aumentados. As amostras do tecido com carcinoma colorretal foram submetidas ao estudo imunoistoquímico, com anticorpo monoclonal anti-CA19-9. A intensidade de expressão do CA19-9 na neoplasia foi semiquantificada em leve (+/+++), moderada (++/+++), intensa (+++/+++) ou ausente. Foram comparados os níveis séricos e a imunoexpressão tecidual do marcador CA19-9 com o comprometimento linfonodal e a invasão linfática. Resultados: O nível sérico e a imunoexpressão tecidual do CA19-9 não se relacionaram significantemente com o comprometimento linfonodal (p = 0,49 e p = 0,45, respectivamente) ou com a invasão linfática (p = 0,12 e p = 0,74, respectivamente). Conclusões: O nível sérico e a imunoexpressão tecidual do CA19-9 não refletem o comprometimento linfonodal e a presença de invasão linfática no carcinoma colorretal.
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Referências
Jantscheff P, Terraciano L, Lowy A, Glatz-Krieger K, Grunert F, Micheel B et al. Expression of CEACAM6 in resectable colorectal cancer: a factor of independent prognostic significance. J Clin Oncol. 2003;21(19):3638-46. http://dx.doi.org/10.1200/JCO.2003.55.135
Instituto Nacional de Câncer. Coordenação de Prevenção e Vigilância de Câncer: Estimativas 2008: incidência de câncer no Brasil. Disponível em: http://www.inca.gov.br. Acessado em 14 de maio de 2010.
Levy M, Visokai V, Lipska L, Topolcan O. Tumor markers in staging and prognosis of colorectal carcinoma. Neoplasma. 2008;55(2):138-42.
Ponz De Leon M, Sant M, Micheli A, Sacchetti C, Di Gregorio C, Fante R et al. Clinical and pathologic prognostic indicators in colorectal cancer. A population-based study. Cancer. 1992;69(3):626-35. http://dx.doi.org/10.1002/1097-0142(19920201)69:3<626::AID-CNCR2820690305>3.0.CO;2-#
Koprowski H, Steplewski Z, Mitchell K, Herlyn M, Herlyn D, Fuhrer P. Colorectal carcinoma antigens detected by hybridoma antibodies. Somatic Cell Genet. 1979;5(6):957-72. http://dx.doi.org/10.1007/BF01542654
Nakagoe T, Sawai T, Tsuji T, Jibiki M, Nanashima A, Yamaguchi H et al. Circulating sialyl Lewis(x), sialyl Lewis(a), and sialyl Tn antigens in colorectal cancer patients: multivariate analysis of predictive factors for serum antigen levels. J Gastroenterol. 2001;36(3):166-72. http://dx.doi.org/10.1007/s005350170124
Carpelan-Holmström M, Louhimo J, Stenman UH, Alfthan H, Järvinen H, Haglund C. Estimating the probability of cancer with several tumor markers in patients with colorectal disease. Oncology. 2004;66(4):296-302. http://dx.doi.org/10.1159/000078330
Salces I, Vegh I, Rodriguez-Mu-oz S, Colina F, Pérez A, Soto S et al. Tissue CA19-9 content in colorectal adenomas and its value in the assessment of dysplasia. Rev Esp Enferm Dig. 2004;96(4):246-54. http://dx.doi.org/10.4321/S1130-01082004000400003
Morales-Gutiérrez C, Vegh I, Colina F, Gómez-Cámara A, Landa IJ, Ballesteros D et al. Survival of patients with colorectal carcinoma: possible prognostic value of tissular carbohydrate antigen 19.9 determination. Cancer. 1999;86(9):1675-81. http://dx.doi.org/10.1002/(SICI)1097-0142(19991101)86:9<1675::AID-CNCR8>3.0.CO;2-9
Nakagoe T, Sawai T, Tsuji T, Jibiki MA, Nanashima A, Yamaguchi T et al. Difference in prognostic value between sialyl Lewis(a) and sialyl Lewis(x) antigen levels in the preoperative serum of gastric cancer patients. J Clin Gastroenterol. 2002;34(4):408-15. http://dx.doi.org/10.1097/00004836-200204000-00005
Shimono R, Mori M, Akazawa K, Adachi Y, Sgimachi K. Immunohistochemical expression of carbohydrate antigen 19-9 in colorectal carcinoma. Am J Gastroenterol. 1994;89(1):101-5.
Fischbach W, Mössner J. Tissue concentrations of CEA and CA 19-9 in the carcinogenesis of colorectal carcinoma exemplified by the adenomacarcinoma sequence. Res Exp Med. 1988;188(2):101-14. http://dx.doi.org/10.1007/BF01852266
Asai S, Watanabe T, Sakamoto J, Kiriyama K, Ito K, Akiyama S et al. Expression and prognostic indicators of type 1 and type 2 Lewis blood group antigens in colorectal cancers. Nippon Geka Gakkai Zasshi. 1994;95(10):753-62.
Franchi F, Pastore C, Izzo P, Calió E. CA19-9 in the monitoring of colorectal cancer after surgery. Med Oncol. 2001;18(3):237-8. http://dx.doi.org/10.1385/MO:18:3:237
Nakayama T, Watanabe M, Teramoto T, Kitajima M. CA19-9 as a predictor of recurrence in patients with colorectal cancer. J Surg Oncol. 1997;66(4):238-43. http://dx.doi.org/10.1002/(SICI)1096-9098(199712)66:4<238::AID-JSO3>3.0.CO;2-C
Nozoe T, Rikimaru T, Mori E, Okuyama T, Takahashi I. Increase in both CEA and CA19-9 in sera is an independent prognostic indicator in colorectal carcinoma. J Surg Oncol. 2006;94(2):132-7.
Wittekind C, Compton CC, Greene FL, Sobin LH. TNM residual tumor classification revisited. Cancer. 2002;94(9):2511-6. http://dx.doi.org/10.1002/cncr.10492
Tempero MA, Uchida E, Takasaki H, Burnett Da, Steplewski Z, Pour PM. Relationship of carbohydrate antigen 19-9 and Lewis antigens in pancreatic cancer. Cancer Res. 1987;47(20):5501-3.
Ueda T, Shimada E, Urakawa T. The clinicopathologic features of serum CA 19-9-positive colorectal cancers. Surg Today. 1994;24(6):518-25. http://dx.doi.org/10.1007/BF01884571
Nakayama T, Watanabe M, Teramoto T, Kitajima M. Slope analysis CA19-9 and CEA for predicting recurrence in colorectal cancer patients. Anticancer Res. 1997;17(2B):1379-82.
Bast RC, Ravdin P, Hayes DF, Bates S, Fritsche H, Jessup JM et al. 2000 update of recommendations for the use of tumor markers in breast and colorectal cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol. 2001;19(6):1865-78.
Chen CC, Yang SH, Lin JK, Lin TC, Chen WS, Jiang JK et al. Is it reasonable to add preoperative serum level of CEA and CA19-9 to staging for colorectal cancer? J Surg Res. 2005;124(2):169-74. http://dx.doi.org/10.1016/j.jss.2004.08.013
Duffy MJ, Van Dalen A, Haglund C, Hansson L, Holinski-Feder E, Klapdor R et al. Tumour markers in colorectal cancer: European Group on Tumour Markers (EGTM) guidelines for clinical use. Eur J Cancer. 2007;43(9):1348-60. http://dx.doi.org/10.1016/j.ejca.2007.03.021
Akamine S, Nakagoe T, Sawai T, Tsuji T, Tanaka K, Hidaka S et al. Differences in prognosis of colorectal cancer patients based on the expression of sialyl Lewisª, sialyl Lewisx, and sialyl LewisTn antigens in serum and tumor tissue. Anticancer Res. 2004;24(4):2541-6.
Nakagoe T, Fukushima K, Nanashima A, Sawai T, Tsuji T, Jibiki M et al. Expression of Lewis(a), sialyl Lewis(a), Lewis(x) and sialyl Lewis(x) antigens as prognostic factors in patients with colorectal cancer. Can J Gastroenterol. 2000;14(9):753-60.
Zheng CX, Zhan WH, Zhao JZ, Zheng D, Wang DP, He YL et al. The prognostic value of preoperative serum levels of CEA, CA19-9 and CA72-4 in patients with colorectal cancer. World J Gastroenterol. 2001;7(3):431-4.
Takada A, Ohmori K, Yoneda T, Tsuyuoka K, Hasegawa A, Kiso M et al. Contribution of carbohydrate antigens sialyl Lewis A and sialyl Lewis X to adhesion of human cancer cells to vascular endothelium. Cancer Res. 1993;53(2): 354-61.
Hayes DF, Bast RC, Desch CE, Fritsche H Jr, Kemeny NE, Jessup JM et al. Tumor marker utility grading system: a framework to evaluate clinical utility of tumor markers. J Natl Cancer Inst. 1996;88(20):1456-66. http://dx.doi.org/10.1093/jnci/88.20.1456