Engarås B, Kewenter J, Nilsson O, Wedel H, Hafström L
Department of Surgery, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
Eur J Surg Oncol. 2001 Feb;27(1):43-8. doi: 10.1053/ejso.2000.1027.
To establish a baseline and intraindividual fluctuations of the tumour markers CEA, CA 50 and CA 242 in patients cured from colorectal cancer, and to test the hypothesis that serum concentrations and intraindividual fluctuations do not differ from the concentrations in cancer-free individuals.
Ninety patients with colorectal cancer, who had undergone surgery with curative intent, were still alive at least 5 years after surgery with no signs of recurrent disease. Serum levels of tumour markers CEA, CA 50 and CA 242 before and up to 2 years after surgery were analysed after the prospective study was terminated.
The pre-operative serum levels of CEA, CA 50 and CEA 242 were elevated in 36%, 16% and 20% of the patients. They were lowered after curative surgery. A small increase of CEA levels was found after the initial post-operative decrease. The intraindividual fluctuations for CA 50 and CA 242 did not exceed 15% but in 24% of the patients the serum levels of CA 50 were high and oscillating. The patients cured from Dukes >> C cancer had higher serum concentrations of CEA than patients who had a Dukes >> B cancer, which were higher than in patients who had Dukes >> A cancer. Concentrations of CA 242 were higher in patients cured from Dukes >> A than patients cured from Dukes>> B or C cancers.
During the first 2 years after curative surgery for colorectal cancer the serum levels of CEA did not differ from those levels in normal cancer-free subjects. The serum levels of CEA were related to Dukes >> staging whereas the levels of CA 242 were inversely related to Dukes >> staging.
建立结直肠癌治愈患者肿瘤标志物癌胚抗原(CEA)、糖类抗原50(CA 50)和糖类抗原242(CA 242)的基线水平及个体内波动情况,并验证血清浓度及个体内波动与无癌个体浓度无差异这一假设。
90例接受了根治性手术的结直肠癌患者术后至少存活5年且无疾病复发迹象。前瞻性研究结束后,分析了手术前及术后2年内肿瘤标志物CEA、CA 50和CA 242的血清水平。
术前血清CEA、CA 50和CA 242水平在36%、16%和20%的患者中升高。根治性手术后这些指标下降。术后最初下降后发现CEA水平有小幅上升。CA 50和CA 242的个体内波动不超过15%,但24%的患者CA 50血清水平较高且波动。 Dukes >> C期癌症治愈患者的CEA血清浓度高于Dukes >> B期癌症患者,而Dukes >> B期癌症患者又高于Dukes >> A期癌症患者。Dukes >> A期癌症治愈患者的CA 242浓度高于Dukes>> B期或C期癌症治愈患者。
结直肠癌根治性手术后的前2年,CEA血清水平与正常无癌受试者的水平无差异。CEA血清水平与Dukes >>分期相关,而CA 242水平与Dukes >>分期呈负相关。