The Clinical Significance of Carcinoembryonic Antigen and CA72-4 Assays of Peritoneal Fluid in Colorectal Carcinomas

ABSTRACT

PURPOSE: CEA and CA72-4 assays in peritoneal fluid offers the greatest advantage in increasing the sensitivity of cytologic diagnosis of carcinomas of the G-I tract. Actually, little investigations have been taken for the relations between CEA and CA72-4 levels in peritoneal fluid and the clinicopathologic characteristics of colorectal carcinomas. The intent of this study was to verify the usefulness of CEA and CA72-4 levels in peritoneal fluid for the treatment of colorectal carcinoma. METHODS: Seventy-three colorectal cancer patients who were hospitalized in our colorectal division were prospectively investigated. Thirty-five out of 73 patients had ascites. Preoperatively, the levels of serum CEA and CA72-4 were measured. At the time of laparotomy, ascites or peritoneal washings were collected from all patients and the levels of carcinoembryonic antigen and CA72-4 were measured and submitted for the analysis to the cytology laboratory. We analyzed the results with the levels of serum CEA and CA72-4, histologic differentiation, location, stage of the tumor, and obstruction due to tumor. RESULTS: The levels of serum CEA and CA72-4 were significantly correlated with those of peritoneal fluid. The elevated levels of CEA and CA72-4 of peritoneal fluid were also significantly correlated with advanced stages of colorectal carcinomas, respectively. But according to histologic differentiation, only CA72-4 levels of peritoneal fluid were elevated in poorly differentiated or mucinous carcinoma. No difference between the levels of CEA and CA72-4 of peritoneal fluid was present in accordance with the location of tumors. CONCLUSIONS: The measurement of CEA and CA72-4 of peritoneal fluid may be valuable method in discriminating between the early-stage versus the late-stage colorectal carcinoma.