Meprin α combined with CEA and CA19-9 improves prognostic prediction for surgically treated colorectal cancer patients

Background: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are generally used as tumour markers in patients with colorectal cancer (CRC), and meprin α might be an additional marker.

Methods: The preoperative expression of serum CEA and CA19-9 was evaluated using a C12 protein biochip system, and tissue meprin α expression in CRC cells was detected by immunohistochemistry. The relationships of these indexes with clinicopathological parameters and the survival of CRC patients were analysed.

Results: Of the 147 CRC patients, the preoperative seropositive rates for CEA and CA19-9 were 51.70% and 44.22%, respectively, and the tissue meprin α positive rate was 39.46%. Preoperative seropositivity for CEA was correlated with tumour size (P = 0.019), T stage (P = 0.005) and staging of CRC based on the American Joint Committee on Cancer (AJCC) guidelines (P = 0.032). The preoperative seropositive rate for CA19-9 was correlated with AJCC tumour stage (P = 0.031). High expression of meprin α was significantly correlated with distant CRC metastasis (P = 0.003), serum CEA (P = 0.002) and serum CA19-9 (P = 0.001). The combination of the three markers was an independent prognostic factor in patients with CRC (HR 3.985, 95% CI 1.106-14.361, P = 0.035 for overall survival).

Conclusions: Tissue meprin α expression may be a useful predictor of metastasis and prognosis in CRC. The combined detection of the three markers may also be helpful to improve the accuracy of CRC prognosis monitoring.