title: A small rise in CEA is sensitive for recurrence after surgery for colorectal cancer.
abstract: OBJECTIVE
  Rise in carcinoembryonic antigen (CEA) above normal limits can indicate recurrent colorectal cancer. The aim of this study was to evaluate whether a small rise in CEA, even within normal limits was a sensitive indicator of recurrence.
  
  
  METHODS
  150 patients aged 22-87 years were followed up for a mean of 27 months after colorectal surgery with CEA 3 and 6 monthly computerized tomography. We analysed whether a rise in CEA > 1 ng/ml correlated with recurrence of metastases.
  
  
  RESULTS
  Forty-six of 139 patients in final analysis had recurrent disease. A rise in CEA > 1 had a predictive value of 74% for recurrence or metastases (sensitivity 80%, specificity 86%). These findings were similar whether or not the CEA was normal preoperatively.
  
  
  CONCLUSIONS
  If CEA is measured after surgery for colorectal cancer, a rise of >1 in the patient's postoperative value is predictive for recurrence or metastases with an overall sensitivity of 80% and specificity of 86%. Previous studies have recognized the role of large rises in CEA in predicting recurrence but this study shows that small changes in CEA may be significant even if these levels would be traditionally within 'normal' limits.
authors.affiliation: Department of Surgery, Whittington Hospital, London, UK. traceyirvine@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Irvine
authors.forename: M
authors.initials: M
authors.lastname: Scott
authors.forename: C I
authors.initials: CI
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D002272:Carcinoembryonic Antigen