Biliary carcinoembryonic antigen in the diagnosis of occult hepatic metastases from colorectal cancer.
OBJECTIVE
Twenty five percent of patients who undergo radical surgical treatment for colorectal cancer have occult hepatic metastases that become evident during the follow-up period. We evaluated whether biliary carcinoembryonic antigen (CEA) measurements could be used in these patients to diagnose occult hepatic metastases.


METHODS
Three groups of patients were enrolled in the study. The first group consisted of patients treated for lithiasis of the common bile duct, the second group was affected by colorectal cancer and evident hepatic metastases, and the third group of patients underwent radical surgical treatment for colorectal cancer but had no evident hepatic metastases.


RESULTS
In the first study group, mean biliary CEA level was 0.52 ng/mL (normal value: 0-5 ng/mL) (diagnostic accuracy: 100%), 83.3 ng/mL in the second group (diagnostic accuracy: 91%) and 3.9 ng/mL in the third group. We registered only one false-positive result in the third group, whereas biliary CEA level was above normal values in the three patients in whom hepatic metastases developed (diagnostic accuracy: 89.5%).


CONCLUSIONS
This study suggests that biliary CEA determination could represent an important method to select patients affected by occult hepatic metastases for inclusion in appropriate treatment protocols.
Li Destri
Giovanni
G
Department of Surgery, University of Catania, Catania, Italy. giolid@tiscalinet.it
Curreri
Roberto
R
Lanteri
Raffaele
R
Gagliano
Giuseppe
G
Rodolico
Margherita
M
Di Cataldo
Antonio
A
Puleo
Stefano
S
D000368:Aged; D001646:Bile / Q000737:chemistry*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012680:Sensitivity and Specificity
D002272:Carcinoembryonic Antigen