Choi J S, Min J S
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1997 Feb;38(1):1-7. doi: 10.3349/ymj.1997.38.1.1.
The postoperative levels of carcinoembryonic antigen (CEA) and the actual half life (T1/2) of CEA were evaluated to ascertain their potency in predicting the recurrence of colorectal cancer after curative surgery in patients who had an abnormally high level of preoperative carcinoembryonic antigen (CEA, > or = 5 ng/ml). Ninety-four patients who underwent curative surgery were enrolled and 24 patients (25.5%) had recurrence during the follow-up period (median: 30 months, range: 2-69 months). T1/2 of CEA for all patients ranged from 1.2 days to 88.1 days, with a median of 4.4 days. T1/2 of CEA (mean +/- standard deviation) was 11.7 +/- 17.9 days in recurrent patients, whereas it was 6.2 +/- 4.9 days in patients without recurrence (p = 0.0224). The patients' age, gender, size of the tumor, location of the tumor, pre-, and postoperative CEA level, pathologic type of the tumor and Dukes stage had no significance in recurrence. The 1-year, 2-year, and 5-year disease-free survival rates were 95.1%, 81.1%, and 73.8% in patients with postoperative CEA levels less than 5 ng/ml (n = 62), respectively, and 71.4%, 64.8%, and 64.8% in patients with postoperative CEA levels higher than or equal to 5 ng/ml (n = 32), respectively (p = 0.04). Patients were divided into Group S (T1/2 of CEA < 4.4 days, n = 43) and Group L (T1/2 of CEA > or = 4.4 days, n = 51). The 1-year, 2-year, and 5-year disease-free survival rates were 95.3%, 85.1%, and 77.7% in Group S, respectively, and 80%, 67.5%, and 64.1% in Group L, respectively (p = 0.0261). In conclusion, the disease-free survival of colorectal cancer patients was prolonged in patients who had a short T1/2 of CEA or a low level of postoperative CEA. In high-risk colorectal cancer patients with an abnormally high level of preoperative CEA, recurrence may be predicted by checking an early postoperative CEA level and/or by a simple calculation of the actual half life of CEA.
对癌胚抗原（CEA）的术后水平及CEA的实际半衰期（T1/2）进行评估，以确定其在术前癌胚抗原（CEA）水平异常升高（CEA≥5 ng/ml）的患者根治性手术后预测结直肠癌复发的效能。纳入94例行根治性手术的患者，24例（25.5%）在随访期间出现复发（中位时间：30个月，范围：2 - 69个月）。所有患者CEA的T1/2为1.2天至88.1天，中位值为4.4天。复发患者CEA的T1/2（均值±标准差）为11.7±17.9天，而未复发患者为6.2±4.9天（p = 0.0224）。患者的年龄、性别、肿瘤大小、肿瘤位置、术前和术后CEA水平、肿瘤病理类型及Dukes分期在复发方面无显著意义。术后CEA水平低于5 ng/ml的患者（n = 62）1年、2年和5年无病生存率分别为95.1%、81.1%和73.8%，术后CEA水平高于或等于5 ng/ml的患者（n = 32）分别为71.4%、64.8%和64.8%（p = 0.04）。患者被分为S组（CEA的T1/2＜4.4天，n = 43）和L组（CEA的T1/2≥4.4天，n = 51）。S组1年、2年和5年无病生存率分别为95.3%、85.1%和77.7%，L组分别为80%、67.5%和64.1%（p = 0.0261）。总之，CEA的T1/2短或术后CEA水平低的结直肠癌患者无病生存期延长。在术前CEA水平异常升高的高危结直肠癌患者中，可通过检查术后早期CEA水平和/或简单计算CEA的实际半衰期来预测复发。
