title: Prognostic value of CEA and CA 19-9 tumor markers combined with cytology from peritoneal fluid in colorectal cancer.
abstract: 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.
authors.affiliation: Department of Surgery, College of Medicine, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. cmcgslee@catholic.ac.kr
authors.forename: In Kyu
authors.initials: IK
authors.lastname: Lee
authors.forename: Do Hyoung
authors.initials: DH
authors.lastname: Kim
authors.forename: D Lee
authors.initials: DL
authors.lastname: Gorden
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Lee
authors.forename: Na Young
authors.initials: NY
authors.lastname: Sung
authors.forename: Gyeoung-Sin
authors.initials: GS
authors.lastname: Park
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Won Kyung
authors.initials: WK
authors.lastname: Kang
authors.forename: Jong Kyung
authors.initials: JK
authors.lastname: Park
authors.forename: Chang Hyeok
authors.initials: CH
authors.lastname: Ahn
authors.forename: Jun-Gi
authors.initials: JG
authors.lastname: Kim
authors.forename: Hae Myung
authors.initials: HM
authors.lastname: Jeon
authors.forename: Seong Taek
authors.initials: ST
authors.lastname: Oh
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen