Prognostic value of CEA and CA 19-9 tumor markers combined with cytology from peritoneal fluid in colorectal cancer.
BACKGROUND
Early diagnosis and management of peritoneal metastases from colorectal cancer patients are difficult clinical challenges. The aims of this study were to evaluate the clinical significance of tumor markers and cytology in peritoneal effusions (PE) and peritoneal irrigation fluid (PI) and to determine their value as prognostic indicators in this disease.


METHODS
Two hundred thirty-four consecutive patients who underwent abdominal surgery for colorectal cancer from January 2006 to December 2007 were included, and tumor markers and cytology in PE and PI were analyzed prospectively.


RESULTS
The incidence of free cancer cells retrieved from peritoneal samples was 7.9%. Cytology was positive in 40.0% by Papanicolaou and Giemsa staining, 73.3% by hematoxylin and eosin staining of cell blocks, and 66.7% by carcinoembryonic antigen (CEA) and calretinin immunohistochemistry. Multivariate analysis revealed that peritoneal CEA and cancer antigen (CA) 19-9 in PI were correlated with peritoneal metastasis and cytology. Level of peritoneal fluid CEA was statistically significantly correlated with recurrence and peritoneal metastatic recurrence in patients with negative peritoneal cytology. Cytology, peritoneal CEA, and peritoneal CA 19-9 showed correlations with cancer-free survival and overall survival.


CONCLUSIONS
These correlations demonstrate the importance of continuous follow-up of peritoneal metastasis if there is positive cytology or an increase in CEA and CA 19-9 in peritoneal fluid.
Lee
In Kyu
IK
Department of Surgery, College of Medicine, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. cmcgslee@catholic.ac.kr
Kim
Do Hyoung
DH
Gorden
D Lee
DL
Lee
Yoon Suk
YS
Sung
Na Young
NY
Park
Gyeoung-Sin
GS
Kim
Hyung Jin
HJ
Kang
Won Kyung
WK
Park
Jong Kyung
JK
Ahn
Chang Hyeok
CH
Kim
Jun-Gi
JG
Jeon
Hae Myung
HM
Oh
Seong Taek
ST
D000368:Aged; D001202:Ascitic Fluid / Q000737:chemistry* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis*; D018395:CA-19-9 Antigen / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D011379:Prognosis
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen