Tanaka Haruka, Mise Yoshihiro, Takahashi Atsushi, Kawano Fumihiro, Takeda Yoshinori, Imamura Hiroshi, Ichida Hirofumi, Yoshioka Ryuji, Saiura Akio
Department of Hepatobiliary-Pancreatic Surgery, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Langenbecks Arch Surg. 2024 Dec 14;410(1):6. doi: 10.1007/s00423-024-03577-5.
The dynamics of postoperative carcinoembryonic antigen (CEA) in pancreatic ductal adenocarcinoma (PDAC) patients have not been well assessed. This study investigated the correlation between postoperative CEA elevations and tumor recurrence.
Medical records were retrospectively analyzed for 84 patients who received curative resection for PDAC from January 2019 to December 2020. Postoperative CEA levels were monitored for a minimum of 12 months. False-positive CEA elevation was defined as a CEA level exceeding 5 ng/mL without evidence of recurrence in imaging studies.
Of the examined patients, 59 (70%) exhibited CEA > 5 ng/mL within the observation period. The sensitivity and specificity of elevated CEA levels for detecting recurrence were 84% and 41%, respectively. CEA elevations without tumor recurrence were observed in 27 patients, indicating a false-positive rate of 59%. More than half of these patients demonstrated peak CEA levels between 5 and 10 ng/mL, while only true-positive patients exhibited CEA levels exceeding 40.0 ng/mL.
CEA may rise in more than half of postoperative PDAC patients without recurrence. CEA alone is not a robust postoperative marker.
胰腺导管腺癌（PDAC）患者术后癌胚抗原（CEA）的动态变化尚未得到充分评估。本研究调查了术后CEA升高与肿瘤复发之间的相关性。
回顾性分析了2019年1月至2020年12月期间接受PDAC根治性切除术的84例患者的病历。术后CEA水平至少监测12个月。假阳性CEA升高定义为CEA水平超过5 ng/mL且影像学检查无复发证据。
在接受检查的患者中，59例（70%）在观察期内CEA>5 ng/mL。CEA水平升高检测复发的敏感性和特异性分别为84%和41%。27例患者观察到CEA升高但无肿瘤复发，假阳性率为59%。这些患者中超过一半的CEA峰值水平在5至10 ng/mL之间，而只有真正复发的患者CEA水平超过40.0 ng/mL。
超过一半的PDAC术后患者CEA可能升高但无复发。单独的CEA不是一个可靠的术后标志物。
