Abstract

COMPARISON BETWEEN TUMOR MARKER CEA, CA19-9 AND SOME MARKER ENZYMES (ALKALINE SPHINGOMYELINASE, CYCLOOXYGENASE-2, THYMIDYLATE SYNTHASE AND ARGINASE) IN SERUM OF COLON CANCER PATIENTS.

M.Sc Noor Abdulaali Azeez*, Assist. Prof. Dr. Sarab Daoud Sulayman Alshamaa, Assist. Prof. Dr. Iman Adel Hadi

ABSTRACT

Carcinoma of the colon was ranked as the sixth cancer among the top ten cancers in Iraq. Different markers are used for different purposes – namely, some of them are more appropriate for the follow-up of the disease and the others for the early detection of the disease recurrence. In many studies, an increase in CA 19-9 has been found to indicate a poor prognosis and high serum levels of either CEA or CA 19-9 in patients with colorectal cancer are significant, independent prognostic factors. Method: 104 patients diagnosed with colon cancer, period March 2013 to April 2014 from the patients treated in Mosul Oncology and Nuclear Medicine Hospital, Ten milliliters of venous blood was taken from each patient, then serum were separated for quantitative measurement of CEA and CA19-9 levels on mini VIDAS (Biomerieux, UK), Alk-SMase, COX2 and THYMS was determined by using ELISA. Arginase enzyme activity was determined according to (kocna et al., 1996) procedure. Results: The statistical analysis of data listed in table (18)show that there was significant difference (P˂0.05) of enzymatic activity for serum (Cyclooxygenase-2, and Arginase) which significantly increase (26.77 ±1.91 U/L, 23.3±2.50 ng/ml) respectively for patients with early stage A colon cancer compared with controls (12.57+1.65 U/L, 4.18±0.34 ng/ml) where as statistical analysis shows non significant increase (P˃0.05) with the levels of CEA and C19–9 tumor marker (4.04±1.6 ng/mL, 10.9±2.1 U/ml) respectively compared with controls (2.8±1.06 ng/mL, 7.2±1.7 U/ml) measured in stage A revealed that (Cyclooxygenase-2 and Arginase) may plays a key role in the early stage of intestinal polypformation. This study also include the measurement of the enzymatic activity of serum alkaline sphingomyelinase which was significantly decreased (P˂0.05) in colon cancer patients (82.21±6.95 U/L) in stage A compared with controls (117.10±6.25 U/L) and this decrease was independent of Dukes stage, thus strengthening the hypothesized validity of this assay to be used as serum test for the early detection of colonic neoplasia. As table (18) show that serum TYMS activities in early stages A, (54.93±25.60 U/L), were non significant increased compared with healthy control (44.22±18.26 U/L). Conclusions: this study shows that these antigenic tumor markers are not sensitive for early colon cancer detection. But these parameters may be used as a prognostic indicator to predict the aggressiveness of the malignant tumor in colon cancer.

Keywords: CEA, CA19-9, Serum Alkaline Sphingomyelinase (Alk-SMase), Human Cyclooxygenase-2(COX2), Serum thymidylate synthase (THYMS) and Arginase, colon Cancer.