Yeh Chien-Yuh, Hsieh Pao-Shiu, Chiang Jy-Ming, Lai Cheng-Chou, Chen Jinn-Shiun, Wang Jeng-Yi, Hung Hsin-Yuan
Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Hepatogastroenterology. 2011 Jul-Aug;58(109):1171-6. doi: 10.5754/hge10564.
BACKGROUND /AIMS: The aim of this study was to calculate the prevalence of elevated carcinoembryonic antigen (CEA) among colorectal cancer (CRC) patients and to evaluate the prognostic value of preoperative serum CEA levels in them.
Between 1995 and 2005, 8,861 consecutive patients were enrolled from a prospective database. CEA =5ng/mL was defined as elevated CEA.
In the multivariate analysis, elevated preoperative CEA correlated with higher ages, circumferential tumors, colon tumors, large tumors, liver metastasis and high-stage (AJCC) tumors. After a 44-month median follow-up, elevated CEA was found to be an independent prognostic factor (odds ratio = 1.61) for overall survival in all 4 stages of the disease. The survival among patients with stage I tumors and elevated CEA (5-year survival rate = 74.7%) was not greater than that among patients with stage II tumors and no CEA elevation (5-year survival rate = 80.8%).
Elevated preoperative CEA correlated with a higher age, circumferential tumors, colon tumors, large tumors, liver metastasis, and high-stage (AJCC) tumors. Elevated preoperative CEA indicates a potential poor prognosis even in early stage tumors. This poorer prognosis in the patients with stage I tumors and elevated preoperative CEA was not cancer specific.
背景/目的：本研究旨在计算结直肠癌（CRC）患者中癌胚抗原（CEA）升高的患病率，并评估术前血清CEA水平对其的预后价值。
1995年至2005年间，从一个前瞻性数据库中纳入了8861例连续患者。CEA≥5ng/mL被定义为CEA升高。
在多变量分析中，术前CEA升高与年龄较大、环周肿瘤、结肠肿瘤、大肿瘤、肝转移和高分期（AJCC）肿瘤相关。经过44个月的中位随访，发现CEA升高是该疾病所有4个阶段总体生存的独立预后因素（优势比=1.61）。I期肿瘤且CEA升高患者的生存率（5年生存率=74.7%）不高于II期肿瘤且CEA未升高患者的生存率（5年生存率=80.8%）。
术前CEA升高与年龄较大、环周肿瘤、结肠肿瘤、大肿瘤、肝转移和高分期（AJCC）肿瘤相关。术前CEA升高表明即使在早期肿瘤中也可能预后不良。I期肿瘤且术前CEA升高患者的这种较差预后并非癌症特异性的。
