What is the role of lab tests in the workup for pediatric colorectal tumors?

Updated: Jun 06, 2020
  • Author: Jaime Shalkow, MD, FACS; Chief Editor: Cameron K Tebbi, MD  more...
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Answer

In the absence of rectorrhagia or hematochezia, patients may test positive for occult blood in the stool; however, screening for fecal occult blood has not proven to be of significant value for the treatment of pediatric patients. [37] Hepatic function abnormalities may be related to metastatic involvement of the liver. Anemia is due to blood loss or malnutrition.

Although fewer than 75% of colon carcinomas in children produce carcinoembryonic antigen (CEA), levels of this protein should be determined. CEA may be a useful tool in identifying recurrent disease after resection, and an increase in CEA levels during follow-up is also related to a higher mortality rate. [12, 59]  However, the role of CEA levels in the diagnosis and follow-up of CRC in children is not well established. [44]

A urine metabolites screening test for colonic adenomas is under development and may be a useful alternative to conventional fecal-based screening tests. Preliminary results show that this urine test has a sensitivity of 82.7% and a specificity of 51.2%, with a negative predictive value of 88.5%, making it a future alternative for excluding colonic polyps. [60]

A blood test that includes miRNA analysis of 5 genes implicated in CRC could constitute a new screening test. Preliminary reports show a predicted specificity of 70-95% and a predictive sensitivity of 83-91%, although more multicenter studies are required. [61]


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