Journal of Surgical Oncology 12: 127-129 (1979)
Carcinoembryonic Antigen (CEA) as Prognostic Marker in Colonic Cancer .......................................................................................... .......................................................................................... ELIAS ALSABTI, MD Radioimmunoassay for serum carcinoembryonic antigen (CEA) was performed in 49 colonic cancer patients. The test results were positive in 42 patients (85.7%) in whom tumor was present at the time of assay. Preoperatively, CEA level suggested the extent and the prognosis of the disease. Strongly positive CEA test results in such patients correlated with metastatic tumors and poor prognosis. Postoperatively, a positive result for serum CEA indicated presence of residual tumor, while negative results did not exclude residual tumor. Periodic CEA determination in the patients who have undergone resection of colonic cancer may detect tumor recurrence that is at a treatable stage. The data show that patients in whom the immediate postoperative CEA concentration returns t o normal have a much lower incidence of recurrent cancer of the colon than patients whose CEA level remains elevated.
.......................................................................................... .......................................................................................... Key words: carcinoembryonic antigen, colonic cancer, radioimmunoassay
INTRODUCTION The demonstration of carcinoembryonic antigen (CEA) in cancer of the colon by Gold and Freedman (1965) and description of a radioimmunoassay for circulating CEA by Thomson and associates have stimulated many clinical studies for diagnostic and prognostic purposes. Preoperative CEA positivity (concentration, 2.5 nglml) has been reported to range from 59 t o 97% in patients with proven cancer of the colon. [Thomson et al, 1969, Moore, 1971, and Holyoke, 19721, and a gross correlation has been noted between the CEA concentration and the extent of the lesion [Herrera et al, 19761. In postoperative follow u p , serial CEA determinations have proved useful in identifying patients in whom recurrence developed. In this study we assess the prognostic value of preoperative and immediate (one t o two weeks) postoperative CEA concentrations in relation to cancer recurrence following curative surgery. From the Royal Scientific Society, Amman, Jordan Address reprint requests to Dr. Elias Alsabti, c/o Mrs. W. Aljaff, Flat No. 5 , 8 Norfolk Terrace, Brighton BN1 3AD, England.
0022-4790/79/1202-0127$01.10@ 1979 Alan R. Liss, Inc.
128
Alsabti
MATERIALS AND METHODS In 49 patients with resectable colonic cancer, plasma CEA concentrations were determined before and 2 weeks after surgery. The patients were divided into two groups depending on their preoperative and postoperative CEA concentrations as follows: group A (21 patients), preoperative CEA value greater than 2.5 ng/ml and less than 2.5 ng/ml postoperatively; and group B (28 patients), both preoperative and postoperative CEA concentrations of more than 2.5 ng/ml. Follow-up in each patient was from 3 to 15 months postoperatively; cancer recurrence was assessed by periodic clinical assessment, operative findings, as well as CEA determinations. Hansen’s technique for radioinimunoassay was used to measure plasma CEA concentration.
RESULTS Recurrence rates of colonic cancer for both groups at 3, 6, 12, and 15 months postoperatively are shown in Figure 1. Rates of recurrence were compared between both groups A and B, both having preoperative CEA concentration more than 2.5 n.g/ml. Expected frequencies of recurrence were calculated from the numbers related to the two groups in Figure 1. Chi-square analysis revealed a significant difference (P
Carcinoembryonic Antigen (CEA) as Prognostic Marker in Colonic Cancer .......................................................................................... .......................................................................................... ELIAS ALSABTI, MD Radioimmunoassay for serum carcinoembryonic antigen (CEA) was performed in 49 colonic cancer patients. The test results were positive in 42 patients (85.7%) in whom tumor was present at the time of assay. Preoperatively, CEA level suggested the extent and the prognosis of the disease. Strongly positive CEA test results in such patients correlated with metastatic tumors and poor prognosis. Postoperatively, a positive result for serum CEA indicated presence of residual tumor, while negative results did not exclude residual tumor. Periodic CEA determination in the patients who have undergone resection of colonic cancer may detect tumor recurrence that is at a treatable stage. The data show that patients in whom the immediate postoperative CEA concentration returns t o normal have a much lower incidence of recurrent cancer of the colon than patients whose CEA level remains elevated.
.......................................................................................... .......................................................................................... Key words: carcinoembryonic antigen, colonic cancer, radioimmunoassay
INTRODUCTION The demonstration of carcinoembryonic antigen (CEA) in cancer of the colon by Gold and Freedman (1965) and description of a radioimmunoassay for circulating CEA by Thomson and associates have stimulated many clinical studies for diagnostic and prognostic purposes. Preoperative CEA positivity (concentration, 2.5 nglml) has been reported to range from 59 t o 97% in patients with proven cancer of the colon. [Thomson et al, 1969, Moore, 1971, and Holyoke, 19721, and a gross correlation has been noted between the CEA concentration and the extent of the lesion [Herrera et al, 19761. In postoperative follow u p , serial CEA determinations have proved useful in identifying patients in whom recurrence developed. In this study we assess the prognostic value of preoperative and immediate (one t o two weeks) postoperative CEA concentrations in relation to cancer recurrence following curative surgery. From the Royal Scientific Society, Amman, Jordan Address reprint requests to Dr. Elias Alsabti, c/o Mrs. W. Aljaff, Flat No. 5 , 8 Norfolk Terrace, Brighton BN1 3AD, England.
0022-4790/79/1202-0127$01.10@ 1979 Alan R. Liss, Inc.
128
Alsabti
MATERIALS AND METHODS In 49 patients with resectable colonic cancer, plasma CEA concentrations were determined before and 2 weeks after surgery. The patients were divided into two groups depending on their preoperative and postoperative CEA concentrations as follows: group A (21 patients), preoperative CEA value greater than 2.5 ng/ml and less than 2.5 ng/ml postoperatively; and group B (28 patients), both preoperative and postoperative CEA concentrations of more than 2.5 ng/ml. Follow-up in each patient was from 3 to 15 months postoperatively; cancer recurrence was assessed by periodic clinical assessment, operative findings, as well as CEA determinations. Hansen’s technique for radioinimunoassay was used to measure plasma CEA concentration.
RESULTS Recurrence rates of colonic cancer for both groups at 3, 6, 12, and 15 months postoperatively are shown in Figure 1. Rates of recurrence were compared between both groups A and B, both having preoperative CEA concentration more than 2.5 n.g/ml. Expected frequencies of recurrence were calculated from the numbers related to the two groups in Figure 1. Chi-square analysis revealed a significant difference (P
![[Carcinoembryonic antigen (CEA) (author's transl)].](/assets/img/hold.png)
