대한대장항문학회

Purpose : Carcinoembryonic antigen (CEA) in now the most widely used and the most<br>useful marker for many cancers, including those of the colon, lung, pancreas, and breast. Also<br>CEA is widely used for detection, staging, recurrence, and assessing the response to therapy<br>in colorectal cancer. Methods : From 1992 to 1998 the clinical value of the pre- and<br>postoperative serum levels of CEA who underwent curative surgery at Department of General<br>Surgery, College of Medicine, Dongguk University KyungJu Hospital, in 140 s patient with<br>colorectal cancer with abnormal levels of CEA (＞or=5 ng/ml) was investigated. Results :<br>The results are as follows: 1) The positive rate of preoperative CEA level was 47%, so<br>preoperative CEA level measurement was not useful as screening test for colorectal cancer. 2)<br>There was no significant association between abnormal CEA level and the location of tumor.<br>3) There was significant association between increased levels of preoperative serum CEA and<br>lymph node metastases. 4) The incidence of preoperatively elevated CEA levels in Dukes<br>stages A, B, C, and D was 0%, 27%, 63%, 71%, respectively. There was significant<br>association between increased levels of the preoperative serum CEA and the progressive<br>stages of colorectal cancers. 5) There was no significant association between abnormal CEA<br>level and histologic differentiation of tumor. In addition, there was no significant association<br>between abnormal CEA level and ploidy status of tumor. 6) The recurrence rate was 20% and<br>77% in patients with preoperative levels of CEA＜5 ng/ml and ＞5 ng/ml, respectively. 7)<br>The recurrence rate was 11% and 64% in patients with postoperative levels of CEA ＜5<br>ng/ml and ＞5 ng/ml, respectively. 8) Considering as normal CEA levels up to 5.0 ng/ml,<br>sensitivity was found to be 77%, specificity, 80%, and predictive value of an elevated CEA<br>concentration, 77%. Conclusions : In conclusion, it is suggested that measurement of<br>preoperative and serial postoperative CEA is very useful in assessing the prognosis and in<br>detecting recurrences in colorectal cancer.<br>