Zs. Zeng et al., USEFULNESS OF CARCINOEMBRYONIC ANTIGEN MONITORING DESPITE NORMAL PREOPERATIVE VALUES IN NODE-POSITIVE COLON-CANCER PATIENTS, Diseases of the colon & rectum, 36(11), 1993, pp. 1063-1068
PURPOSE: The aim of our study was to determine to what extent serial c
arcinoembryonic antigen (CEA) monitoring is helpful in detecting color
ectal cancer recurrence in patients if their preoperative serum CEA is
normal. Additional major objectives of this study were to correlate C
EA immunohistochemical features of the primary tumor with serum CEA le
vels at the time of tumor recurrence in node-positive colorectal cance
r patients with low preoperative CEA values. METHODS: One hundred four
teen node-positive colorectal cancer patients with preoperative serum
CEA levels of <5.0 ng/ml undergoing clinically curative operations wer
e studied. Primary tumors were evaluated for tissue CEA using the same
monoclonal antibody as used for serum CEA determinations utilizing th
e avidin-biotin-peroxidase immunohistochemical technique. RESULTS: The
exact preoperative serum CEA value did not correlate with tumor grade
, immunohistochemical CEA intensity or pattern. In the 32 patients who
developed recurrent cancer, the serum CEA at recurrence was greater t
han 5 ng/ml in 44 percent. All such patients had CEA present in their
primary tumor. There was no correlation with the exact preoperative se
rum CEA, the intensity of the primary tissue CEA, or the localization
of such CEA and subsequent serum elevation at recurrence. CONCLUSION:
Serum CEA is a useful marker in the detection of recurrent colorectal
cancer despite normal preoperative values.