Detection of occult liver metastases by measurement of biliary carcinoembryonic antigen concentrations.
OBJECTIVE
To assess whether biliary CEA concentrations can be used as early markers of occult liver metastases in patients with colorectal cancer.


METHODS
Consecutive open study.


METHODS
University hospital, The Netherlands.


METHODS
76 patients with a primary colorectal carcinoma (group 1) and 19 patients who had recently undergone a curative resection of a locally advanced carcinoma (group 2).


METHODS
Bile sampling by transhepatic puncture of the gallbladder.


METHODS
Recurrence of tumour.


RESULTS
Twenty-one of the 76 patients (28%) with primary colorectal carcinoma had liver metastases; all had a raised biliary CEA concentration. Of the remaining 55 patients 39 (71%) also had raised CEA concentrations. At a median follow-up of 30 months, only seven patients had developed liver metastases, indicating a high number of false-positive results. In Group 2 7/19 patients (37%) had a CEA concentration above the cut-off point. Six of them developed recurrent tumour; 2 patients had liver metastases and 4 others had extrahepatic recurrences. None of the 12 patients with biliary CEA concentrations within the reference range has developed recurrent tumour.


CONCLUSIONS
Biliary CEA concentrations do not predict the presence of occult liver metastases if bile samples are taken during resection of the primary tumour. If samples are taken some time afterwards, a raised CEA concentration seems to predict recurrence at an early stage, either in or outside the liver.
Paul
M A
MA
Department of Surgery, Free University Hospital, Amsterdam, The Netherlands.
Visser
J J
JJ
Mulder
C
C
Blomjous
J G
JG
van Kamp
G J
GJ
Cuesta
M A
MA
Meijer
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000737:chemistry*; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local
D002272:Carcinoembryonic Antigen