The upregulation of fecal cytokeratin 19 (CK19) correlates with age and metastatic status in human colorectal cancer (CRC). To further explore its clinical significance in older patients (>60 years), their fecal CK19 was measured by quantitative reverse transcription-polymerase chain reaction. Differences in CK19 transcripts were compared using the nonparametric Mann-Whitney U test. Clinical significance was assessed with the chi-squared test and a binary logistic regression model. The association between overall survival and expressions of fecal CK19 in combination with other serum markers, carcinoembryonic antigen and carbohydrate antigen 19-9 (CA19-9), was evaluated using the Kaplan-Meier method. In these older groups, CRC patients had significantly higher median fecal CK19 expression (p = 0.006) than controls. The highest risk of CRC (odds ratio, 5.8; 95% confidence interval, 2.3-14.7; p < 0.001) was detected when the cutoff value for fecal CK19 expression was set at the median value of the 28 healthy controls. The lowest overall survival (29.2% ± 21.4%) occurred in patients in whom serum CA19-9 levels were high and fecal CK19 was overexpressed. Our results suggest that fecal CK19 expression is associated with CRC, and together with serum carcinoembryonic antigen or CA19-9, it can predict overall survival in older patients.
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