Intest Res.  2018 Jul;16(3):467-474. 10.5217/ir.2018.16.3.467.

Clinical significance of carcinoembryonic antigen in peritoneal fluid detected during operation in stage I–III colorectal cancer patients

• Kim JH
• Lee S
• Lee SH
• Ahn BK
• Baek SU
• Moon W
• Park SJ

• KMID: 2417659
• DOI: http://doi.org/10.5217/ir.2018.16.3.467

Abstract

BACKGROUND/AIMS
Early diagnosis of peritoneal metastases in patients with colorectal cancer (CRC) can influence patient prognosis. The aim of this study was to identify the clinical significance of carcinoembryonic antigen (CEA) in peritoneal fluid detected during operation in stage I-III CRC patients.
METHODS
Between April 2009 and April 2015, we reviewed medical records from a total of 60 stage I-III CRC patients who had peritoneal fluid collected during operation. Patients who had positive cytology in the assessment of peritoneal fluid were excluded. We evaluated the values of CEA in peritoneal fluid (pCEA) to predict the long-term outcomes of these patients using Kaplan-Meier curves and Cox regression models.
RESULTS
The median follow-up duration was 37 months (interquartile range, 21-50 months). On receiver operating characteristic analysis, pCEA had the largest area under the curve (0.793; 95% confidence interval, 0.635-0.950; P=0.001) with an optimal cutoff value of 26.84 (sensitivity, 80.0%; specificity, 76.6%) for predicting recurrence. The recurrence rate was 8.1% in patients with low pCEA ( < 26.84 ng/mL, n=37), and 52.2% in patients with high pCEA (≥26.84 ng/mL, n=23). In multivariate Cox regression analysis, high pCEA (≥26.84 ng/mL) was a risk factor for poor cancer-free survival (CFS) in stage I-III patients.
CONCLUSIONS
In this study, we determined that high pCEA (≥26.84 ng/mL) detected during operation was helpful for the prediction of poor CFS in patients with stage I-III CRC.

Keyword

Carcinoembryonic antigen; Peritoneal fluid; Operation; Colorectal neoplasms

MeSH Terms

Ascitic Fluid*
Carcinoembryonic Antigen*
Colorectal Neoplasms*
Early Diagnosis
Follow-Up Studies
Humans
Medical Records
Neoplasm Metastasis
Prognosis
Recurrence
Risk Factors
ROC Curve
Sensitivity and Specificity
Carcinoembryonic Antigen

Figure

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  Fig. 1 Receiver operating characteristics curves for predicting recurrence of stage I–III colorectal cancer.

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  Fig. 2 Recurrence rates of stage III colorectal cancer according to CEA in peritoneal fluid (pCEA).

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  Fig. 3 Correlation between CEA in peritoneal fluid (pCEA) and CEA in serum (sCEA).

• 

  Fig. 4 Kaplan-Meier curves shows the cancer-free survival for patients with stage I–III colorectal cancer according to the level of (CEA in peritoneal fluid) pCEA.

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