Chu D Z, Erickson C A, Russell M P, Thompson C, Lang N P, Broadwater R J, Westbrook K C
Department of Surgery, University of Arkansas for Medical Sciences, Little Rock.
Arch Surg. 1991 Mar;126(3):314-6. doi: 10.1001/archsurg.1991.01410270054010.
The use of carcinoembryonic antigen was evaluated in 425 patients with a mean follow-up of 48 months. The preoperative and postoperative carcinoembryonic antigen levels were predictive of recurrence and survival independent of the tumor stage. In a multivariate regression analysis of age, location, tumor stage, and preoperative and postoperative carcinoembryonic antigen levels, the latter three factors were significant prognostic variables with respect to the adjusted survival. Recurrent disease was found in 42% of patients, excluding patients with stage IV disease. The carcinoembryonic antigen level at recurrence was greater than 5 ng/mL in 79% of the patients and in 89% of the intra-abdominal recurrences. Carcinoembryonic antigen level at recurrence was not predictive of postrecurrence survival except in the subgroup of locoregional disease. The life span in patients with liver and lung metastases was not influenced by carcinoembryonic antigen level at recurrence. Preoperative and postoperative carcinoembryonic antigen levels can indicate a poorer prognostic group of patients with colorectal cancer who may benefit from adjuvant treatment. The carcinoembryonic antigen at recurrence can be used effectively to diagnose intra-abdominal recurrences and project survival after development of local/regional disease.
对425例患者使用癌胚抗原进行评估，平均随访48个月。术前和术后癌胚抗原水平可独立于肿瘤分期预测复发和生存情况。在对年龄、位置、肿瘤分期以及术前和术后癌胚抗原水平进行的多因素回归分析中，后三个因素是调整后生存的显著预后变量。排除IV期疾病患者后，42%的患者出现复发性疾病。79%的患者复发时癌胚抗原水平大于5 ng/mL，89%的腹腔内复发患者也是如此。除局部区域疾病亚组外，复发时的癌胚抗原水平不能预测复发后的生存情况。肝转移和肺转移患者的生存期不受复发时癌胚抗原水平的影响。术前和术后癌胚抗原水平可表明一组预后较差的结直肠癌患者，他们可能从辅助治疗中获益。复发时的癌胚抗原可有效用于诊断腹腔内复发，并预测局部/区域疾病发生后的生存情况。
