The prognostic value of serum carcinoembryonic antigen in colorectal carcinoma

• Autores: Vincenzo Aiello Crocifoglio, Luis Fernando Oñate Ocaña, Carlos M. López Graniel, Dolores Gallardo Rincón, Ricardo Mondragón-Sánchez
• Localización: Revista de oncología: Publicación oficial de la Federación de Sociedades Españolas de Oncología y del Instituto Nacional de Cancerología de México, ISSN 1575-3018, Vol. 5, Nº. 4 (mayo), 2003, págs. 212-217
• Idioma: inglés
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• Resumen

  • Background. Carcinoembryonic antigen (CEA) is a non-specific tumor marker, however some clinical applications have been reported.

    Aims. Our aim is to define the role of pretherapeutic serum CEA level (SCEAL) as prognostic factor and to describe the usefulness of serial SCEAL in the follow-up of Mexican patients with completely resected colorectal carcinoma (CRC).

    Patients and methods. A retrospective cohort study of 580 patients with CRC treated in Mexico City in a 12-year period. The Cox's model was used to evaluate prognostic factors predicting survival and the logistic regression model was used to test recurrence determinants in completely resected CRC. Sensitivity and specificity for SCEAL as diagnostic aid of recurrence after complete resection is reported and receiver-operating characteristic curve (ROC) analysis was performed to choose the best cutoff point.

    Results. Histologic grade, Dukes' stage, curative resection and age were independent factors determining survival. Preoperative SCEAL was not found to be significant, however a bivariate correlation between preoperative SCEAL and Dukes' stage was found. Dukes' stage and specially lymph node metastasis were significant recurrence determinants in completely resected CRC. The sensitivity and specificity of serial SCEAL as diagnostic aid for recurrence after complete resection was 58% and 91%, respectively, using 10 ng/ml as cutoff point.

    Conclusions. Preoperative SCEAL is neither a significant prognostic factor nor a significant determinant of recurrence. Serial SCEAL has a limited role in the follow-up of patients with completely resected CRC. However, the high specificity for diagnosis of recurrences supports its use in CEA-based second-look surgery.