Bile Carcinoembryonic Antigen in Colorectal Cancer

ABSTRACT

PURPOSE: Serum level of carcinoembryonic antigen (CEA) is clinically one of the prognostic factors in the follow-up evaluation of the colorectal cancer (CRC) patient. It has been recently suggested that the bile CEA level is also useful in early detection of the liver metastasis of colrectal cancer. If the bile CEA is also correlated with the cancer progression or prognosis like as serum CEA, it will be another useful clinical parameter in the evaluation and treatment of CRC patients. Therefore this study is aimed to reveal the correlation of the bile CEA with the progression of tumor and to estimate the possibility of bile CEA as a useful clinical parameter. METHODS: Preoperative serum levels of CEA were measured in 58 patients of CRC who were operated in Pundang CHA hospital. The levels of bile CEA were also checked with the aspiration of bile in gall bladder at laparotomy. The positive value of CEA was settled as more than 5ng/ml. RESULTS: The 58 patients were classified into 29 cases of Dukes'AB group, 23 cases of Dukes'C group & 6 cases of Dukes'D group. The positive rates of serum CEA were 24.1% in AB group, 30.4% in C group & 66.7% in D group, and those of bile CEA were 44.8%, 56.5% & 83.3% individually. When group C was also divided into N1(13 cases) & N2 (10 cases) groups according to the number of the metastatic lymph nodes, serum & bile CEA positive rates were 15.4% & 46.1% in N1 group, and 50% & 70% in N2 group. Both of serum & bile CEA levels were all positive and markedly elevated in 4 hepatic metastasis cases of group D. CONCLUSIONS: Positive rate of bile CEA was increased according to the progression of tumor stage. Marked elevation of bile CEA was especially noted in liver metastatic cases. Therefore bile CEA can be considered as a clinical parameter in evaluation of cancer progression & prognosis like as serum CEA, and also as a useful indicator of hepatic metastasis.