Li Destri Giovanni, Curreri Roberto, Lanteri Raffaele, Gagliano Giuseppe, Rodolico Margherita, Di Cataldo Antonio, Puleo Stefano
Department of Surgery, University of Catania, Catania, Italy.
J Surg Oncol. 2002 Sep;81(1):8-11. doi: 10.1002/jso.10143.
Twenty five percent of patients who undergo radical surgical treatment for colorectal cancer have occult hepatic metastases that become evident during the follow-up period. We evaluated whether biliary carcinoembryonic antigen (CEA) measurements could be used in these patients to diagnose occult hepatic metastases.
Three groups of patients were enrolled in the study. The first group consisted of patients treated for lithiasis of the common bile duct, the second group was affected by colorectal cancer and evident hepatic metastases, and the third group of patients underwent radical surgical treatment for colorectal cancer but had no evident hepatic metastases.
In the first study group, mean biliary CEA level was 0.52 ng/mL (normal value: 0-5 ng/mL) (diagnostic accuracy: 100%), 83.3 ng/mL in the second group (diagnostic accuracy: 91%) and 3.9 ng/mL in the third group. We registered only one false-positive result in the third group, whereas biliary CEA level was above normal values in the three patients in whom hepatic metastases developed (diagnostic accuracy: 89.5%).
This study suggests that biliary CEA determination could represent an important method to select patients affected by occult hepatic metastases for inclusion in appropriate treatment protocols.
接受结直肠癌根治性手术治疗的患者中，有25%存在隐匿性肝转移，这些转移在随访期间会变得明显。我们评估了胆汁癌胚抗原（CEA）检测是否可用于这些患者隐匿性肝转移的诊断。
三组患者纳入本研究。第一组由因胆总管结石接受治疗的患者组成，第二组患有结直肠癌且有明显肝转移，第三组患者接受了结直肠癌根治性手术，但无明显肝转移。
在第一研究组中，胆汁CEA平均水平为0.52 ng/mL（正常值：0 - 5 ng/mL）（诊断准确率：100%），第二组为83.3 ng/mL（诊断准确率：91%），第三组为3.9 ng/mL。第三组仅记录到1例假阳性结果，而发生肝转移的3例患者胆汁CEA水平均高于正常值（诊断准确率：89.5%）。
本研究表明，胆汁CEA测定可能是选择隐匿性肝转移患者纳入适当治疗方案的重要方法。
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