Chapman M A, Buckley D, Henson D B, Armitage N C
Department of Surgery, University Hospital, Queens Medical Centre, Nottingham, UK.
Br J Cancer. 1998 Nov;78(10):1346-9. doi: 10.1038/bjc.1998.682.
Evidence as to the value of preoperative carcinoembryonic antigen (CEA) in guiding treatment for patients with colorectal cancer is conflicting. The aim of this prospective study was to investigate the value of preoperative CEA in predicting tumour factors of proven prognostic value and long-term survival in patients undergoing surgery for colorectal cancer. Preoperative serum CEA, tumour ploidy, stage and grade were ascertained in 277 patients undergoing colorectal cancer surgery. This cohort of patients were followed up for a minimum of 5 years, or until death, in a dedicated colorectal clinic. Patients with an elevated CEA had a 5 year survival of 39%. This increased to 57% if the CEA was normal (P=0.001). The proportion of patients with a raised CEA increased with a more advanced tumour stage (P < 0.000001) and a poorly differentiated tumour grade (P < 0.005). Once stage had been controlled for, CEA was not a predictor of survival. No relationship between tumour ploidy and CEA was found. In conclusion, a raised preoperative serum CEA is likely to be associated with advanced tumour stage and poor long-term survival, compared with patients with a normal value.
关于术前癌胚抗原（CEA）在指导结直肠癌患者治疗方面的价值，证据存在矛盾。这项前瞻性研究的目的是探讨术前CEA在预测接受结直肠癌手术患者的已证实具有预后价值的肿瘤因素和长期生存方面的价值。对277例接受结直肠癌手术的患者测定了术前血清CEA、肿瘤倍体、分期和分级。在一个专门的结直肠诊所对这组患者进行了至少5年的随访，直至死亡。CEA升高的患者5年生存率为39%。如果CEA正常，这一比例升至57%（P=0.001）。CEA升高的患者比例随着肿瘤分期的进展（P < 0.000001）和肿瘤分级差（P < 0.005）而增加。一旦控制了分期，CEA就不是生存的预测指标。未发现肿瘤倍体与CEA之间存在关联。总之，与CEA值正常的患者相比，术前血清CEA升高可能与肿瘤分期进展和长期生存不良有关。
