Prognostic and therapeutic score for colorectal adenomas and the role of serum and tissue carcinoembryonic antigen.
OBJECTIVE
To study the tissue carcinoembryonic antigen (TCEA) concentrations with regard to multiplicity, diameter, pathohistological finding, degree of dysplasia and serum CEA (SCEA) concentrations.


METHODS
Our study included 46 patients with single or multiple adenomas. For 56 adenomas TCEA concentrations were measured in addition to standard determinations of multiplicity, diameter, pathohistology, degree of dysplasia and SCEA. The measurements of TCEA concentrations were performed using the CEA-EIA method (Abbott) modified for wet tissue obtained from the head of the adenoma (TCEA-A), margin of resection at the neck or base of the adenoma (TCEA-B), mucosa near the adenoma (TCEA-C) and rectal mucosa (TCEA-D). The Mann-Whitney test and M estimates were used to differentiate CEA distribution between various classes of adenomas within each characterization.


RESULTS
TCEA concentrations from the head of the adenoma (TCEA-A) demonstrated highly significant difference between mild and severe dysplasia (P = 0.0003), between mild dysplasia and invasive adenocarcinoma (P = 0.001) and significant difference between mild and moderate dysplasia (P = 0.04). There was a statistically significant difference in TCEA-A also between tubular and villous adenomas (P = 0.04). On the other hand, no significant correlations with regard to multiplicity, diameter and pathohistological features were found.


CONCLUSIONS
These results suggest that there is a highly significant difference between the tissue CEA concentration from the head of the adenoma (TCEA-A) in the presence or absence of severe dysplasia. Furthermore, combining a number of pathological variables together with TCEA and routine SCEA, a new score was proposed to be used as a guide to the frequency of follow-up colonoscopy following polypectomy.
Rosandić
M
M
Department of Internal Medicine, University Hospital, Rebro, Zagreb, Croatia.
Paar
V
V
D000236:Adenoma / Q000097:blood / Q000276:immunology* / Q000473:pathology; D002272:Carcinoembryonic Antigen / Q000032:analysis* / Q000097:blood; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000097:blood / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D011379:Prognosis
D002272:Carcinoembryonic Antigen