Value of carcinoembryonic antigen in the management of colorectal cancer.
OBJECTIVE
The practical value of carcinoembryonic antigen (CEA) assay in the management of colorectal cancer after surgery is controversial. The value of CEA in the management of colorectal cancer was reviewed and discussed to justify the use of CEA assay in the management of colorectal cancer.


METHODS
A retrospective study was performed on 318 patients who underwent resection by one surgeon (JYW) between 1981 and 1986 and who were followed for a minimum of 5 years or until death.


RESULTS
The incidence of preoperative CEA levels > 5 ng/ml in Dukes Stages A, B, C, and D were 0, 32, 48, and 79 percent, respectively. Five-year survival rates for groups with CEA levels < or = 5 ng/ml and > 5 ng/ml were 85 percent and 55 percent (P < 0.05), respectively, in Dukes Stage B patients and 64 percent and 37 percent (P < 0.05) in Stage C patients. The sensitivity and specificity of postoperative CEA monitoring in detecting recurrent diseases were 66 percent and 94 percent, respectively, for patients with a preoperative CEA value < or = 5 ng/ml and 97 percent and 88 percent for patients with a higher preoperative CEA value.


CONCLUSIONS
CEA is still the best tumor marker available to be used as an independent prognostic factor and as a monitor for recurrence of disease after primary tumor resection.
Wang
J Y
JY
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
Tang
R
R
Chiang
J M
JM
D000230:Adenocarcinoma / Q000097:blood / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D011182:Postoperative Care; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate
D002272:Carcinoembryonic Antigen