Clinical meaning of age-related expression of fecal cytokeratin 19 in colorectal malignancy

The quantitation of fecal CK19 transcript was determined by a quantitative real-time reverse transcription polymerase chain in 129 CRC patients (45 younger than 60 years at diagnosis) and 85 healthy controls. The levels of CK19 protein were examined both in colonic cell lines and tissues.The analysis of 45 younger CRC patients (age ≤ 60 years) revealed that patients at the M1 stage had significantly higher expression levels of fecal CK19 mRNA when compared with healthy controls (p < 0.001) and patients at the M0 stage (p = 0.004). Additionally, the degree of consistency between the mean level of fecal CK19 mRNA and the distant metastatic rate in each age interval was up to 89% (p = 0.042).These results indicate that high levels of fecal CK19 mRNA represent a potential marker for colorectal malignancy and for aggressive treatment of younger CRC patients.Colorectal cancer (CRC), which is a predominant gastrointestinal malignancy, is one of the most commonly diagnosed tumors in both men and women, and is becoming one of the major medical causes of economic burden worldwide [1]. On average, the starting age of CRC incidence begins at 40 years of age and rises sharply at the age of 50-55 years [2]. Moreover, CRC is also the second most common cause of cancer-related deaths among men over 40 years of age [3].Several clinicopathological features of CRC have been studied to identify markers that could predict CRC outcomes [4]. Numerous studies have shown that metastasis through the blood or lymphatic vessels is a major complication of cancer, and affects the prognosis of patients with primary carcinomas [5], therefore, methods developed to detect disseminated tumor cells in the peripheral blood and lymph nodes of patients have been evaluated. Many genetic changes were found in metastatic tumors, and some of them could be molecular markers for disseminated tumor cells [6]. CRC development and progression were shown to be complex processes that are associated with multiple ge