CA 19-9 and CEA Expression in Mucinous and Non-Mucinous Colorectal Carcinoma and the Impact on Prognosis and Clinicopathological Features

Alaa Edin, Hala S. E; Foda, Abd AlRahman Mohammad; MK, Elsamman; Enan, Eman T.

doi:10.21608/svuijm.2025.384427.2177

CA 19-9 and CEA Expression in Mucinous and Non-Mucinous Colorectal Carcinoma and the Impact on Prognosis and Clinicopathological Features

Document Type : Original research articles

Authors

¹ Pathology Department, Faculty of Medicine, South Valley University, Qena, Egypt.

² Anatomic Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt & Department of Pathology, General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia.

³ Internal Medicine Department, Faculty of Medicine, Sohag University, Sohag, Egypt.

⁴ Anatomic Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

10.21608/svuijm.2025.384427.2177

Abstract

Background: One of the most prevalent cancers in the world and a major contributor to cancer-related mortality is colorectal cancer (CRC). Carbohydrate antigen CA 19-9 and Carcinoembryonic antigen (CEA) are adhesion molecules that play a role in cancer cell activity, and are used to assess patients with gastrointestinal tumors.
Objectives: Evaluation of CEA and CA19-9 expression in CRC, compare the mucinous and non-mucinous CRC expression, and correlate the findings with clinicopathological data.
Patients and methods: 150 cases CRC, 75 mucinous carcinoma (MA), 19 signet ring CRC, and 75 non-mucinous carcinoma. Tissue Microarray blocks were created and stained with CA19-9 and CEA.
Results: CEA expression was significantly linked to younger age, schistosomiasis, and histologic subtype in MA (P = 0.001, 0.005, and 0.010), CA19-9 was associated with smaller tumors, and lymphovascular invasion (P = 0.013, and 0.043) in MA. In NMA tumors, the CEA positivity was higher in ordinary adenocarcinoma than in adenocarcinoma with < 50% mucinous components (p = 0.010). Co-expression of CEA and CA19-9 was significant in MA (P = 0.033). Positive CEA expression correlated with improved disease-free (P = 0.014) and overall survival (P = 0.008) in MA cases only.
Conclusion: CEA and CA19-9 are prognostic markers in CRC. CEA is associated with younger age and schistosomiasis in MA, while CA19-9 correlates with smaller tumors and less lymphovascular invasion. Co-expression of these markers is characteristic of MA. Positive CEA expression predicts better survival in MA cases.

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