Journal
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
Volume 51, Issue 7, Pages 860-865Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/00365521.2016.1144783
Keywords
CA19-9; CEA; colorectal cancer; diverticula; endoscopy; malignancy; TIMP-1; YKL-40
Categories
Funding
- Danish Cancer Society
- Kornerup Fund
- Aage and Johanne Louis-Hansen Fund
- Aase and Ejnar Danielsen Fund
- Walter and O. Kristiane Christensen Fund
- Kathrine and Vigo Skovgaard Fund
- Den Midtjyske Bladfond
- Agnes and Poul Friis Fund
- Glunz and Jensen Fund
- Sophus and Astrid Jacobsen Fund
- Arvid Nilsson Fund
- Danish Bank Fund
- Johannes Fog Fund
- Eva and Henry Fraenkel Fund
- Hartmann Bros. Fund
- KID Fund
- Henrik Henriksen Fund
- King Christian X's Fund
- Oda and Hans Svenningsen Fund
- Else and Mogens Wedell-Wedellsborg Fund
- Einar Willumsen Fund
- Willy and Ingeborg Reinhard Fund
- Friedrich and Else Boehm Fund
- Toyota Fund Denmark
- IMK Fund
- Danish Medical Research Fund
- Beckett Fund
- Hvidovre University Hospital
- The Danish Cancer Society [R89-A6106] Funding Source: researchfish
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Background: Frequently, subjects offered colonoscopy due to symptoms of colorectal neoplasia are diagnosed with diverticula. The symptoms may, however, also be related to extra-colonic neoplasia. The present retrospective study evaluated a possible association between increased levels of predefined biomarkers in subjects diagnosed with diverticula and risk of developing a primary malignant disease. Methods: During 2004/2005, about 4509 subjects were included in a multicenter study with collection of blood samples before bowel endoscopy. The aim was to evaluate a relation between the protein biomarkers CEA, TIMP-1, CA19-9 and YKL-40 and findings at endoscopy. Diverticula were diagnosed in 1021 subjects. By 31 December 2012, subjects who had developed primary malignancy were identified retrospectively and relation between biomarker levels at endoscopy and risk of developing primary malignancy was calculated. The relation with the four biomarkers was divided into three groups: 0 = none increased; 1 = one increased and 2 = two or more increased. Results: In the observation period, 148 subjects developed a primary malignant disease. Univariable analyzes of the biomarker levels showed that CEA, TIMP-1 and CA19-9 were significantly associated with development of primary malignancy. A multivariable analysis showed that increased levels were associated with development of malignancy (p< 0.0001). The 1-and 5-year cumulative risks of being diagnosed with a primary malignancy were: group 0: 1.1%/5.5%; group 1: 4.2%/10.1% and group 2: 11.4%/18.8%, respectively. Conclusion: Increased levels of CEA, TIMP-1 and CA19-9 at endoscopy with findings of diverticula were associated with a significantly increased risk of being diagnosed with a subsequent primary malignant disease.
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