癌胚抗原在结直肠癌管理中的价值。

Value of carcinoembryonic antigen in the management of colorectal cancer.

作者信息

Wang J Y, Tang R, Chiang J M

机构信息

Department of Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.

出版信息

Dis Colon Rectum. 1994 Mar;37(3):272-7. doi: 10.1007/BF02048166.

DOI:10.1007/BF02048166

PMID:8137675

Abstract

PURPOSE

The practical value of carcinoembryonic antigen (CEA) assay in the management of colorectal cancer after surgery is controversial. The value of CEA in the management of colorectal cancer was reviewed and discussed to justify the use of CEA assay in the management of colorectal cancer.

METHODS

A retrospective study was performed on 318 patients who underwent resection by one surgeon (JYW) between 1981 and 1986 and who were followed for a minimum of 5 years or until death.

RESULTS

The incidence of preoperative CEA levels > 5 ng/ml in Dukes Stages A, B, C, and D were 0, 32, 48, and 79 percent, respectively. Five-year survival rates for groups with CEA levels < or = 5 ng/ml and > 5 ng/ml were 85 percent and 55 percent (P < 0.05), respectively, in Dukes Stage B patients and 64 percent and 37 percent (P < 0.05) in Stage C patients. The sensitivity and specificity of postoperative CEA monitoring in detecting recurrent diseases were 66 percent and 94 percent, respectively, for patients with a preoperative CEA value < or = 5 ng/ml and 97 percent and 88 percent for patients with a higher preoperative CEA value.

CONCLUSION

CEA is still the best tumor marker available to be used as an independent prognostic factor and as a monitor for recurrence of disease after primary tumor resection.

摘要

目的

癌胚抗原（CEA）检测在结直肠癌术后管理中的实用价值存在争议。对CEA在结直肠癌管理中的价值进行综述和讨论，以证明CEA检测在结直肠癌管理中的应用合理性。

方法

对1981年至1986年间由同一外科医生（JYW）进行手术切除且随访至少5年或直至死亡的318例患者进行回顾性研究。

结果

在Dukes分期A、B、C和D期患者中，术前CEA水平>5 ng/ml的发生率分别为0%、32%、48%和79%。在Dukes B期患者中，CEA水平≤5 ng/ml和>5 ng/ml组的5年生存率分别为85%和55%（P<0.05）；在C期患者中，分别为64%和37%（P<0.05）。术前CEA值≤5 ng/ml的患者术后CEA监测检测复发性疾病的敏感性和特异性分别为66%和94%，术前CEA值较高的患者分别为97%和88%。