Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Gwangju, Korea.
J Surg Oncol. 2010 Apr 1;101(5):396-400. doi: 10.1002/jso.21495.
We evaluated the prognostic value of the preoperative serum carcinoembryonic antigen (CEA) level in patients with colon cancer.
We reviewed 474 patients who underwent potentially curative resection for nonmetastatic colon cancer. Patients were categorized into two groups according to the preoperative serum CEA level: low CEA (<5 ng/ml) and high CEA (>or=5 ng/ml) groups.
During the median 45-month follow-up period, the 5-year overall and disease-free survival rates for patients with a low CEA level were 81.7% and 82.4%, respectively, which were significantly higher than the rates for those with a high CEA level (69.9%; P = 0.011 and 70.6%; P = 0.002, respectively). A multivariate analysis revealed that a preoperative serum CEA level was a significant independent prognostic factor for both overall survival (P = 0.021) and disease-free survival (P = 0.026). Both the overall and disease-free survival rates in patients with stage II tumors differed significantly between the low and high CEA groups, whereas the rates did not different between those with stage I and III tumors.
Preoperative serum CEA is a reliable predictor of recurrence and survival after curative surgery in patients with colon cancer, particularly in those classified as having stage II disease.
我们评估了术前血清癌胚抗原（CEA）水平在结肠癌患者中的预后价值。
我们回顾了 474 例接受非转移性结肠癌潜在根治性切除术的患者。根据术前血清 CEA 水平将患者分为两组：低 CEA（<5ng/ml）组和高 CEA（≥5ng/ml）组。
在中位 45 个月的随访期间，低 CEA 组患者的 5 年总生存率和无病生存率分别为 81.7%和 82.4%，明显高于高 CEA 组（69.9%，P=0.011 和 70.6%，P=0.002）。多因素分析显示，术前血清 CEA 水平是总生存（P=0.021）和无病生存（P=0.026）的独立预后因素。Ⅱ期肿瘤患者的总生存率和无病生存率在低 CEA 组和高 CEA 组之间差异有统计学意义，而Ⅰ期和Ⅲ期肿瘤患者的生存率无差异。
术前血清 CEA 是结肠癌患者根治术后复发和生存的可靠预测指标，尤其在Ⅱ期疾病患者中。
