SERUM CARCINOEMBRYONIC ANTIGEN LEVELS AND PROLIFERATING CELL NUCLEAR ANTIGEN LABELING INDEX FOR PATIENTS WITH COLORECTAL-CARCINOMA - CORRELATION WITH TUMOR PROGRESSION AND SURVIVAL

BACKGROUND. Clinicopathologic variables, carcinoembryonic antigen (CEA ), nuclear DNA ploidy, and proliferating cell nuclear antigen labeling index (PCNA LI) have been studied for their effect on patients with v arious types of cancer. METHODS. Thirteen clinicopathologic variables, preoperative serum CEA levels, PCNA LI, DNA ploidy patterns, and surv ival were studied for 57 colorectal carcinoma patients, and the mutual relation between these variables, tumor progression, and survival wer e analyzed. RESULTS. Seven variables including undifferentiated adenoc arcinoma, deep invasion, lymphatic and venous invasion, node metastasi s, liver metastasis, and advanced stages were significantly greater fo r patients with positive CEA (> 5.0 ng/mL) than for patients with nega tive CEA (< 5.0 ng/mL). Three variables including deep invasion, liver metastasis, and advanced stages were significantly greater for patien ts with high PCNA LI (> 49.4%) than for patients with low PCNA LI (< 4 9.4%). No significant difference was observed in any of the variables for patients with DNA diploid or aneuploid cancer. A close relationshi p representing a formula, Y (log CEA, ng/mL) = 0.026X (PCNA LI, %) - 0 .478, was found between CEA level and PCNA LI. Survival curves for pat ients with negative CEA and low PCNA LI were significantly greater tha n those for patients with positive CEA and high PCNA LI. Survival curv es were significantly greater for patients with positive CEA and low P CNA LI than for patients with positive CEA and high PCNA LI. However, no significant difference was observed in the survival curves of patie nts with different DNA ploidy patterns. CONCLUSIONS. Serum CW and PCNA LI for cancer patients is useful in the evaluation of tumor progressi on and in prognosis. Analysis of DNA ploidy appears to be unavailable for this evaluation. (C) 1996 American Cancer Society.