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KMID : 0371319920430020183
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Journal of the Korean Surgical Society
1992 Volume.43 No. 2 p.183 ~ p.195
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Assessment of Prognostic Role of Serum Carcinoembryonoic Antigen(CEA) Monitoring in Patients with Stomach, Colorectal and Breast Cancers
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Abstract
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Pre-and postoperative serum carcinoembryonic antigen(CEA) values were serially determined by enzyme immunoassay in 84 patients with stomach cancer, 50 patients with colorectal cancer and 31 patients with breast cancer operated on with curative
intention
from Jan. 1983 through Dec. 1989, and its various prognostic values were analyzed retrospectively. Mean follow up period was 23 months in stomach cancer, 22 months in colorectal cancer and 31 months in breast cancer patients. Persistent elevation
of
serum CEA value over 6 weeks following curative resection in patients with abnormal preoperative CEA value indicated potential residual disease in one half of stomach or colorectal cancer patients and one third of breast cancer patients. Although
preoperative CEA value had positive correlation with possibility of CEA elevation at recurrence in stomach cancer and also similar trend observed in colorectal and breast cancer patients, it did not determine cancer recurrence rate itself. Rising
CEA
values from at least 3 months before clinical signs for cancer recurrence were observed in only less than one third of each cancer patients. Sensitivity for cancer recurrence was 84% in colorectal cancer, 68% in stomach cancer and 67% in breast
cancer
patients, and overall specificity or positive predictive value were approximately 80% and 70% respectively, which were not statistically different in each cancer patients. Preoperative CEA value itself did not show any correlation with median
disease
free interval or median duration of survival in recurrent stomach or colorectal cancer patients as well as cumulative recurrence free survival or overall survival rates in each cancer patients.
These results indicated that although postoperative serial CEA determinations in stomach, colorectal and breast cancer patients are valuable in detection of residual disease or prediction of early recurrence, and can provide diagnostic or
predictive
values for cancer recurrence, its role as clinical marker for early detection of disease recurrence in asymptomatic patients is limited, and that preoperative CEA value itself cannot provide prognostic information.
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KEYWORD
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