An evaluation of markers in the early detection of large bowel cancer

In colon cancer biologic markers have been successfully utilized to follow the course of disease, to evaluate response to therapy, and to predict recurrence. With the exception of occult blood measurements, there has been little success in adopting markers to early diagnosis. The role of CEA in predicting the course of the disease is considered, as well as the utility of combining serum enzyme measurements and carcinoembryonic antigen (CEA) assays for these purposes. Aryl sulfatase B has been correlated to the stage of the disease, and enzymes involved in the metabolism of glycoproteins (sialyltransferase and glucosyltransferase) may be of importance in monitoring colon cancer. Polyamines have been observed in blood and urine of patients with a variety of cancers and their presence during therapy in increased amounts may reflect cancer cell death as well as tumor growth. Their use in diagnosis and chemo-therapeutic monitoring in colon cancer has not yet been established. Another area of possible use of biologic markers is their measurement in colon washings. This is discussed in regard to the assay of CEA and enzymes in colonic lavage.