[Does an obturation in colorectal cancer also modify the behavior of the serum CEA level?].
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The CEA-plasma level was determined in 10 patients with malignant obstruction of the large intestine and in 6 patients with benign obstruction of the small intestine. The plasma carcinoembryonic antigen levels were obtained prior to initiating of the treatment and sequentially after treating the complete obstruction. Elevated plasma carcinoembryonic antigen levels are related to the carcinoembryonic antigen production by the primary tumour and not additionally to the obstruction. An elevated plasma CEA level in patients with benign obstruction could not be detected. After relief of obstruction, significant changes in the mean carcinoembryonic antigen values could not be observed.Keywords:
Carcinoembryonic antigen
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First-line treatment of metastatic colorectal cancer with combinations of cetuximab and irinotecan-based or oxaliplatin-based chemotherapy has shown promising efficacy. The clinical response to such treatment is generally assessed by tumor measurement through imaging. This study was performed to evaluate the correlation between serial changes in imaging results and carcinoembryonic antigen (CEA) levels. In 64 patients with metastatic colorectal cancer receiving cetuximab plus FOLFIRI or FOLFOX-4 chemotherapy we retrospectively analyzed the relationship between changes in serum CEA and changes in imaging results throughout the treatment course. Response in terms of serum CEA change was defined as a >/=50% drop in CEA level for more than 4 weeks. The sensitivity and specificity of serum CEA changes after targeted chemotherapy in relation to imaging results were 80.5% (33/41) and 73.9% (17/23), respectively, with a diagnostic accuracy of 78.1% (50/64). The progression-free survival time of responders assessed by serum CEA change was significantly longer than that of nonresponders (p=0.0091). Our results highlight the importance of serum CEA monitoring in assessing the response to targeted chemotherapy and in predicting the prognosis of patients with metastatic colorectal cancer.
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Carcinoembryonic antigen
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Carcinoembryonic antigen (CEA) levels in the feces and serum were evaluated in 22 colorectal cancer patients and 20 healthy volunteers; in CEA levels gastric juice and serum were also evaluated in 28 gastric cancer patients and 14 peptic ulcer patients. Fecal CEA was found in all of 22 colorectal cancer patients as well as in the 20 healthy volunteers. Elevated fecal CEA levels were observed in the colorectal cancer patients, as compared to the healthy volunteers. The feces of 15 of the 22 colorectal cancer patients contained CEA at concentrations higher than the mean value plus twice the standard deviation of the healthy volunteers. The fecal CEA levels did not correlate directly either with Dukes' stage or serum CEA levels. CEA in gastric juice was elevated significantly in 26 of gastric cancer patients, with the exception of two patients with early gastric cancer. On the other hand, serum CEA was elevated in only nine of the 28 gastric cancer patients. These results point out the distinct value of assaying CEA in the feces or gastric juice as an aid in the diagnosis of colorectal or gastric cancer.
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Colonic cancer
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This study was conducted to define the clinical significance of intraoperative determination of carcinoembryonic antigen levels in peritoneal washes from patients undergoing surgery for colorectal cancer.The correlation of carcinoembryonic antigen levels in peritoneal washes (pCEA) with several clinicopathological factors and the long-term surgical outcome in 54 patients with resectable colorectal cancer was determined retrospectively.Among several clinicopathological factors, the depth of tumor invasion significantly and independently correlated with pCEA levels as revealed by multivariate stepwise logistic regression analysis. A significant difference in overall survival rates was observed between pCEA-positive and pCEA-negative groups: five-year survival rates were 97.1% in pCEA-negative patients and 78.9% in pCEA-positive patients (p = 0.0274).Intraoperative determination of carcinoembryonic antigen levels in peritoneal washes could be a potentially predictive factor of a poor prognosis in patients with colorectal cancer.
Carcinoembryonic antigen
Colonic cancer
Cancer antigen
Stepwise regression
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Objective To investigate the clinical effects of surgical operation on colorectal cancer complicated by bowel obstruction. Methods Treatment methods and clinical efficacies were analyzed in 42 patients with colorectal cancer and bowel obstruction. Results Standardized surgical procedures were successfully completed in all patients. Average intraoperative blood loss and mean operating time were(172.4 ±22.2)mL and(148.5 ±16.0)min, respectively. The total effective rate was 64.3%. The incidence of complications was 7.1%(1 case of incision infection and 1 case of cardiovascular disease). No patients died during 3 months of follow-up. The serum levels of carcinoembryonic antigen and carbohydrate antigen CA19-9 gradually decreased over time(P0.05).Conclusion Appropriate surgical approach should be selected according to the patient's condition to improve curative efficacies, reduce complications and increase survival in patients with colorectal cancer and bowel obstruction.
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Carcinoembryonic antigen
Microgram
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Carcinoembryonic antigen
Clinical Oncology
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Compared with minimal follow-up after surgery for colorectal cancer, intensive follow-up with regular computed tomography (CT), carcinoembryonic antigen (CEA) testing, or both results in more patients undergoing repeat surgery but no reduction in overall mortality or disease-specific mortality.
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Cancer surgery
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Carcinoembryonic antigen
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Objective To explore the clinical significance of testing serum methylated Sept9 gene (mSEPT9) in diagnosis of colorectal cancer.Methods The subjects were divided into three groups,79 cases in colorectal cancer group,73 cases in colorectal polyps group and 146 cases in healthy control group.The mSEPT9 in peripheral blood serum were detected by the polymerase chain reaction (PCR) fluorescence probe method.The relation between positive rate of the gene and clinical pathological characteristics of colorectal cancer was analyzed.Furthermore the positive rate was compared with that of carcinoembryonic antigen (CEA) and (or) carbohydrate antigen 19-9 (CA19-9).Chi-square test and Chisquare test with continuity correction were performed for statistical analysis.Results The positive rate of mSEPT9 was 71.05％ (54/76),5.80％ (4/69) and 3.68％ (5/136),in plasma of colorectal cancer group,colorectal polyps group,and healthy control group,respectively.The positive rate of mSEPT9 of colorectal cancer group was significantly higher than that of the other two groups (x2=141.700,P＜ 0.01).The sensitivity and specificity of serum mSEPT9 in detecting patients with colorectal cancer was 71.05 ％ and 95.61％,respectively.The positive rate of mSEPT9 was higher in patients with colorectal tumor over 5.0 cm,serosa layer or surrounding tissue invaded by the lesions,adenocarcinoma and clinical stage Ⅳ,which was 88.46％ (23/26),78.57％ (44/56),74.63％ (50/67) and 8/10,respectively,and the differences were statistically significant (x2 =6.635,8.661,3.333 and 10.969,all P＜0.05).Compared with other serum tumor markers,the positive rate of mSEPT9 was higher than that of CEA,CA19-9 alone and CEA,CA19-9 joint detection in patients with colorectal cancer,which was 71.05 ％ (54/ 76),34.21％ (26/76),18.42％ (14/76) and 40.79％ (31/76),respectively.The differences were statistically significant (x2 =20.689,42.577 and 14.119,all P＜0.01).Conclusions The positive rate of mSEPT9 was high in plasma of patients with colorectal cancer.The detection of this gene played an important role in the diagnosis of colorectal cancer.
Key words:
Colorectal neoplasms; Sept9 DNA; Methylation
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Clinical Significance
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First-line treatment of metastatic colorectal cancer with combinations of cetuximab and irinotecan-based or oxaliplatin-based chemotherapy has shown promising efficacy. The clinical response to such treatment is generally assessed by tumor measurement through imaging. This study was performed to evaluate the correlation between serial changes in imaging results and carcinoembryonic antigen (CEA) levels. In 64 patients with metastatic colorectal cancer receiving cetuximab plus FOLFIRI or FOLFOX-4 chemotherapy we retrospectively analyzed the relationship between changes in serum CEA and changes in imaging results throughout the treatment course. Response in terms of serum CEA change was defined as a >/=50% drop in CEA level for more than 4 weeks. The sensitivity and specificity of serum CEA changes after targeted chemotherapy in relation to imaging results were 80.5% (33/41) and 73.9% (17/23), respectively, with a diagnostic accuracy of 78.1% (50/64). The progression-free survival time of responders assessed by serum CEA change was significantly longer than that of nonresponders (p=0.0091). Our results highlight the importance of serum CEA monitoring in assessing the response to targeted chemotherapy and in predicting the prognosis of patients with metastatic colorectal cancer.
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FOLFIRI
Carcinoembryonic antigen
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