The Value Of Serum Carcinoembryonic Antigen(CEA) In Clinical Stages And Prognosis Of Colotectal Cancer

OBJECTIVE to detect the expression of preoperative serumcarcinoembryonic antigen(CEA) in colorectal cancer(CRC),evaluate thefunction of CEA in colorectal cancer(CRC).METHOD The data includes735primary colorectal cancerpatients that diagnosed and recieving radical resection in gastric andintestine department from January2002to September2012in Guangximedical university affiliated oncological hospital.To analyze the collecteddata of colorectal cancer,baseline factors including smoking,drinking,tumor site;Six factors were in the observing data includinghistologic tumor types,clinical stages,clinical stages,preoperativeserum CEA.Preoperative serum CEA was tested with the method ofChemiluminescence and the cutoff value was assumed as5ng/ml(negative group<=5ng/ml, positive group>5ng/ml). The dateobtained were built database with Excel2003and were analyzed with theStatistical Package for the Social Sciences Version16.0software.Count data was analyzed with X2test.Kaplan-Meier analyses were included intoLog-rank models,A value of p <0.05was considered as statisticallysignificant.Results (1)In the study,the positive rate of CEA was higher thanthe negative rate in right colon of CRC,the difference was statisticallysignifican（t26.16%vs16.30%，P=0.001）；the positive rate of CEA washigher than the negative rate in poorly-differentiated colorectalcarcinomas,the difference was statistically significant （70.57%vs52.17%，P=0.000）；the positive rate of CEA was higher than the negativerate in stage III and stage IV colorectal carcinomas,the difference wasstatistically significant（88.55%vs64.94%，P=0.000）；There were nosignificant difference between positive and negative rate of CEA indrinking and smoking groups(p>0.05).(2)In the study, the positive rate of CEA was lower than thenegative rate of CEA for5year survival rate in the colorectal cancerpatients after radical resection.There were significant difference betweenthe two group（s30.09%vs59.51%，P<0.0001）.The positive rate of CEAwas lower than the negative rate of CEA for5year survival rate in thecolorectal cancer patients of stage I.There were no significant differencebetween the two groups（80%vs100%，P=0.0652）；.5year survival rateof patients of II stage in positive CEA group was obviously lower than itin negative CEA group.There were significant difference between the twogroups（80.10%vs95.50%，P=0.00278）；5year survival rate of patientsof III stage in positive CEA group was similar to the negative CEA group （32.86%vs37.72%，P＞0.05）；5year survival rate of patients of IVstage in positive CEA group was similar to the negative CEAgroup(9.14%vs5.94%，P＞0.05)；There were no significant differenceabout5year survival rate in positive and negative CEA groups of patientsin III-IV stages（P＞0.05）.⑶Multivariate analysis shows the factors that affect the survival ofpatients that underwent radical resection were as follows: differentiationof tumor（OR=1.669；95%CI：1.389-2.004，P=0.000）,clinical stag（OR=13.791；95%CI：10.791-17.975，P=0.000）.Smoking,drinking,tumor site, Preoperative serum CEA were not independent factorsaffecting the survival of CRC patients（P＞0.05）.Conclusion Preoperative serum CEA has certain value in thejudging therapeutic effect, monitoring disease development andevaluating prognosis of CRC.Serum CEA detection may be one of theprognostic factors for patients in I-II stage.When serum CEA of patientsin I-II are highly expressed,it will predict poor prognosis.Therefore,necessary treatments should be taken into action after radicalresection;but preoperative serum CEA is not independently prognosticfactor for patients of III-IV stage.