This report is a clinical study of 158 patients who underwent operation for cancer of the colorectum at. Hanyang University Hospital and who had either preoperative liver scan, alkaline phosphatase or carcinoembryonic antigen between March 1979 to January 1984.
A sensitive and economic method of screening for liver- metastases in patients with colorectal cancer was developed using serum alkaline phosphatase and carcinoembryonic antigen.
The upper limit of normal value for serum alkaline phosphatase and carcinoembryonic antigen did not represent the optimal levels for use in predicting liver metastases. However, in predicting liver metastases in colorectal cancer patients with alkaline phosphatase greater than 115 I.U., and/or carcinoembryonic antigen greater than 10 ng/ml, sensitivity was 94.4 %, specificity was 84.3%, false positive rate was 15.7% and false negative rate was 5.6% 17 of 18 patients with liver metastases fulfilled either or both criteria. With liver scan in predicting liver metastases of colorectal cancer patients, sensitivity was 77.8% specificity was 96.2%, false positive rate was 3.8% and false negative rate was 22.2%.
Therefore, patients with carcinoembryonic antigen greater than 10 ng/dl and/or alkaline phosphatase level greater than 115 I.U. would subsequently undergo liver scan, ultrasono-gram or computed tomography to verify suspected metastases.
This would reduce the expense and time and produce the excellent result.
|