Detection of occult liver metastases in colorectal cancer by measurement of biliary carcinoembryonic antigen.

About a 20-25% of the patients at diagnosis of colorectal carcinoma present with occult liver metastases. The aim of this work was to determine the prognostic significance of CEA bile level for the early detection of occult metastases. We determined the CEA blood level and the CEA bile level in 182 patients with colorectal carcinoma (3 Dukes' stage A, 86 Dukes' stage B, 53 Dukes' stage C, and 40 patients with liver metastases) and also in 42 patients with simple cholelithiasis, as the control group. In the patients with cholelithiasis, the mean values of CEA serum and bile levels were normal. In patients with colorectal carcinomas the CEA serum levels ranged from 3 to 110 ng/ml, and the CEA bile level from 3 to 226 ng/ml. Patients with liver metastases, had a mean CEA serum level of 193 ng/ml, while CEA bile level was 1,225 ng/ml. In conclusion, our results suggest that the determination of CEA bile is highly useful in the diagnosis of occult liver metastases.