Clinical significance of carcinoembryonic antigen (CEA) in patients with adenocarcinoma in colon and rectum.

Determination of carcinoembryonic antigen (CEA) in serum has been performed in 253 patients with proved adenocarcinoma in the colon and rectum. Preoperative CEA was normal in 58.3% of the patients. A correlation between CEA level and Dukes' grading was found. There was, however, no statistically significant difference in recurrence rate between patients with normal and patients with elevated pre-operative CEA. Transient CEA elevation was seen in the follow-up period after curative resection in 21.8%. 75% of the patients with recurrence had abnormal CEA, and CEA elevation was the first sign of recurrence in 59.1%. The majority of these patients, however, had advanced disease not available for surgical treatment. In cases with local resectable tumour CEA often was normal. Only a few patients had advantage of CEA determination for diagnosis of recurrence and its routine use is therefore questioned.