J Korean Surg Soc.  1997 Aug;53(2):234-242.

Significance of CEA Levels in Peripheral Venous Blood, Drainage Venous Blood, and Gallbladder Bile in Perdiciting Hepatic Metastases of Colorectal Cancer

• Yoon SG
• Chung SJ
• Woo ZH
• Choi KW

Abstract

Despite major diagnostic advances, 10-30% of hepatic metastases of colorectal carcinoma remain undetected. In this study, CEA levels of peripheral (p-CEA), drainage venous blood(d-CEA) and gallbladder bile(b-CEA) in patients with colorectal cancer were determined to examine the significance of their CEA levels in predicting hepatic metastases. From January 1993 through May 1996, p-CEA, d-CEA and b-CEA were obtained in 50 colorectal carcinoma patients without gallbladder pathology. Synchronous hepatic metastases were found in 5 patients(Hm group) and 45 cases had no hepatic metastasis. Among the 27 cases who followed up over 2 years, metachronous hepatic metastases(Hr group) were found in 6 cases and remaining 21 cases had no metastases(Ho group). Elevation of p-CEA, d-CEA, and b-CEA was significantly correlated with lymph node metastases and hepatic metastasis. The b-CEA levels were significantly correlated with p-CEA(r=0.533926, p<0.0001) while d-CEA levels were not(r=0.276437, p=0.0520). Although all the levels of p-CEA, d-CEA, and b-CEA in Hr & Hm group were significantly higher than those in Ho group, d-CEA level was considered as most sensitive index in predicting hepatic metastases(mean 12.7 ng/ml in Ho, 88.6 in Hr, and 137.3 in Hm group. p<0.0001). The possible cut-off level of d-CEA was 40 ng/ml because all of the cases with d-CEA < 40 ng/ml had no hepatic metastasis nor hepatic recurrance, whereas 11 out of 12 patients with d-CEA > 40 ng/ml had hepatic metastases(5 synchronous, 6 metachronous). However it is impossible to establish the possible of b-CEA because of high false positive and negative rate in predicting metachronous hepatic metastases. In conclusion, it is suggested that d-CEA could be highly sensitive indicator for selecting high-risk patients of metachronous hepatic metastases of colorectal cancer.

Keyword

Colorectal cancer; Carcinoembryonic antigen (CEA); Drainage vein; Gallbladder bile; Hepatic metasteses

MeSH Terms

Bile*
Colorectal Neoplasms*
Drainage*
Gallbladder*
Humans
Lymph Nodes
Neoplasm Metastasis*
Pathology