Carcinoembryonic antigen is the preferred biomarker for in vivo colorectal cancer targeting

Br J Cancer. 2013 Feb 19;108(3):662-7. doi: 10.1038/bjc.2012.605. Epub 2013 Jan 15.

Abstract

Background: Colorectal cancer-specific biomarkers have been used as molecular targets for fluorescent intra-operative imaging, targeted PET/MRI, and selective cytotoxic drug delivery yet the selection of biomarkers used is rarely evidence-based. We evaluated sensitivities and specificites of four of the most commonly used markers: carcinoembryonic antigen (CEA), tumour-associated glycoprotein-72 (TAG-72), folate receptor-α (FRα) and Epithelial growth factor receptor (EGFR).

Methods: Marker expression was evaluated semi-quantitatively in matched mucosal and colorectal cancer tissues from 280 patients using immunohistochemistry (scores of 0-15). Matched positive and negative lymph nodes from 18 patients were also examined.

Results: Markers were more highly expressed in tumour tissue than in matched normal tissue in 98.8%, 79.0%, 37.1% and 32.8% of cases for CEA, TAG-72, FRα and EGFR, respectively. Carcinoembryonic antigen showed the greatest differential expression, with tumours scoring a mean of 10.8 points higher than normal tissues (95% CI 10.31-11.21, P<0.001). Similarly, CEA showed the greatest differential expression between positive and negative lymph nodes. Receiver operating characteristic analyses showed CEA to have the best sensitivity (93.7%) and specificity (96.1%) for colorectal cancer detection.

Conclusion: Carcinoembryonic antigen has the greatest potential to allow highly specific tumour imaging and drug delivery; future translational research should aim to exploit this.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Neoplasm / metabolism
  • Biomarkers, Tumor / metabolism*
  • Carcinoembryonic Antigen / metabolism*
  • Case-Control Studies
  • Colon / metabolism*
  • Colorectal Neoplasms / metabolism*
  • Colorectal Neoplasms / pathology
  • ErbB Receptors / metabolism
  • Female
  • Folate Receptor 1 / metabolism
  • Follow-Up Studies
  • Glycoproteins / metabolism
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Rectum / metabolism*

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Folate Receptor 1
  • Glycoproteins
  • tumor-associated antigen 72
  • EGFR protein, human
  • ErbB Receptors