[Leukocyte migration test and determination of carcinoembryonic antigens in the postoperative follow-up care of colon and rectum carcinoma].

Preoperative and serial postoperative CEA determinations have become widely accepted tools to aid the early detection of recurrent colorectal cancer. The panel modification of the direct leukocyte migration test (LMT) has proved to be an excellent monitor in these tumor patients. In this study LMT and CEA-RIA were compared. Peripheral blood leukocytes were pulsed with a high dose (2.5 and 0.5 mg/ml) of 3 m KCl extracts of five different colorectal tumors as well as with one 3m KCL extract of normal colonic mucosa. Patients showing a pathologic migration index (less than 0.80 and greater than 1.17) of 3 or more out of five tumor extracts were considered to be "positives." With this test mode 51 of 59 (86%) patients with resectable tumors were reactive, while only 24 of 69 (41%) yielded elevated CEA values. Both LMT and CEA-RIA were positive in 12 of the 13 patients with nonresectable tumors. After curative surgery most patients' leukocyte migration and CEA values were in tne normal range. Of the nine patients with localized tumor recurrence, eight were LMT reactive and five showed elevated CEA values. Of five patients with distant metastases, four demonstrated a positive reaction in the LMT and five a rise in CEA levels. The combination of the LMT with the CEA-RIA promises to improve the detection of recurrent colorectal cancer before the appearance of clinical evidence of recurrence.