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Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 28, 2006; 12(24): 3891-3894
Published online Jun 28, 2006. doi: 10.3748/wjg.v12.i24.3891
Value of carcinoembryonic antigen and cytokeratins for the detection of recurrent disease following curative resection of colorectal cancer
Luís C Fernandes, Su B Kim, Sarhan S Saad, Delcio Matos
Luís C Fernandes, Su B Kim, Sarhan S Saad, Delcio Matos, Coloproctology Sector, Department of Surgical Gastroenterology, Federal University of São Paulo-Escola Paulista de Medicina, São Paulo, Brazil
Author contributions: All authors contributed equally to the work.
Supported by Foundation for Research Support of the State of São Paulo-FAPESP, No. 98/12504-1
Correspondence to: Luís César Fernandes, MD, UNIFESPEPM, Alameda Santos, n. 211, conj. 304, Paraíso, São Paulo, SP01419-000, Brazi. luiscfernandes@terra.com.br
Telephone: +55-11-32877231 Fax: +55-11-32511662
Received: September 27, 2005
Revised: November 11, 2005
Accepted: November 18, 2005
Published online: June 28, 2006
Abstract

AIM: To evaluate the efficacy of postoperative serial assay of carcinoembryonic antigen (CEA) and cytokeratins for the detection of recurrent disease in patients with colorectal adenocarcinoma after radical surgery.

METHODS: Between 1993 and 2000, 120 patients with colorectal adenocarcinoma underwent radical surgery in the Department of Surgical Gastroenterology, Federal University of São Paulo-Escola Paulista de Medicina, São Paulo, Brazil. Periodic postoperative evaluation was performed by assaying markers in peripheral serum, colonoscopy and imaging examination. Presence of CEA was detected using the Delfia® method with 5 μg/L threshold, and cytokeratins using the LIA-mat® TPA-M Prolifigen® method with 72 U/L threshold.

RESULTS: In the first postoperative year, patients without recurrent disease had normal levels of CEA (1.5 ± 0.9 μg/L) and monoclonal tissue polypeptide antigen-M (TPA-M, 64.4 ± 47.8 U/L), while patients with recurrences had high levels of CEA (6.9 ± 9.8 μg/L, P < 0.01) and TPA-M (192.2 ± 328.8 U/L, P < 0.05). During the second postoperative year, patients without tumor recurrence had normal levels of CEA (2.0 ± 1.8 μg/L) and TPA-M (50.8 ± 38.4 U/L), while patients with recurrence had high levels of CEA (66.3 ± 130.8 μg/L, P < 0.01) and TPA-M (442.7 ± 652.8 U/L, P < 0.05). The mean follow-up time was 22.3 mo. There was recurrence in 23 cases. Five reoperations were performed without achieving radical excision. Rises in tumor marker levels preceded identification of recurrences: CEA in seven (30%) and TPA-M in eleven individuals (48%).

CONCLUSION: Intensive follow-up by serial assay of CEA and cytokeratins allows early detection of colorectal neoplasm recurrence.

Keywords: Colorectal neoplasms; Cytokeratin; Carcin-oembryonic antigen; Residual neoplasm