The Effect of Tumor Manipulation on Serum Carcinoembryonic Antigen Levels in Colorectal Cancer Patients

ABSTRACT

PURPOSE:Tumor cells can be shed into a venous blood stream by manipulation of tumor during surgery, resulting metastasis to distant organs from the primary tumor. In order to elucidate the effect of early lymphovascular dissection prior to tumor mobilization, we studied the difference in carcinoembryonic antigen (CEA) values of tumor draining veins before and after tumor mobilization. METHODS:Blood samples were taken from the tumor draining veins of sixteen patients during operations. The lymphovascular dissection was performed before the tumor mobilization, and the main draining vein from the tumor was isolated and the proximal end was ligated and blood samples were taken, then the tumor mobilization was made. Just before the removal of the tumor, we took the second sets of blood samples from the same sites. RESULTS:There were no significant differences in CEA values between peripheral blood (1.8+/-1.2 ng/mL) and tumor draining veins before the tumor mobilization. The mean CEA value of draining veins after the tumor mobilization (14.3+/-11.9 ng/mL) was significantly higher than that of draining veins before the mobilization (2.2+/-2.1 ng/mL)(P<0.001). CONCLUSIONS:Theses results suggest that early lymphovascular dissection procedures before tumor mobilization can reduce the opportunity of tumor cell dissemination into draining vein.