A CLINICOPATHOLOGICAL STUDY OF THE CORRELATION OF CARCINOEMBRYONIC ANTIGEN IN COLORECTAL CARCINOMA: IN A TERTIARY CARE MEDICAL COLLEGE SET-UP IN EASTERN INDIA

Abstract

Introduction: Carcino embryonic antigen(CEA) is overexpressed primarily by adenocarcinomas including colon, rectum, breast and lung. It should be noted that more than 90% of primary colorectal carcinomas produce CEA.CEA is a classic tumour marker for CRC, which is used to monitor the recurrence of the disease and as a prognostic factor for the patients. In the present scenario, the serum CEAtest is recommended by the American Society of Clinical Oncology and the European Group on Tumor Markers 7 as a prognostic biomarker for recurrent CRC following curative resection. Aims: To study the distribution of carcinoembryonic antigen in colorectal carcinoma, the role of carcinoembryonic antigen in the prognosis of colorectal carcinoma, to the variability of carcinoembryonic antigen values in recurrence of colorectal carcinoma and the sensitivity and specicity of carcinoembryonic antigen estimation in colorectal cancer Material And Method: This Institution based observational and prospective study was all the adult patients(>18yrs) who have been diagnosed clinically with colorectal carcinoma and with recurrent disease in the Department of General surgery of R.G.Kar medical college and hospital from January 2019 to August 2020 were included in this study. Result: 10% of the patients were in Duke stage A, 16% patients were Duke stage B; 40% patients were with Duke stage C and 34%patients were Duke stage D of colorectal carcinoma. Among those 13 patients with Duke A and B staging 30% had increased CEA, whereas among those 37 patients with Duke stage C and D 92% had increased CEA levels. The p-value was found to be 0.00033 that is<0.05,which meant the test was statistically signicant. 80%(n=38) of the patients with colon carcinoma had increased CEAvalues whereas 20%(n=2) of the patients had normal CEAvalues. 77%(n=7) patients in the rectal carcinoma group had increased CEAlevels whereas in 23%(n=3) patients it was normal. Conclusion:This study shows an increased amount of CEAlevels in the preoperative period then the patient's chances of recurrence and metastasis increases, hence having a poor prognosis. Regular surveillance through serial monitoring of the CEAlevels in the postoperative period is essential to be vigilant of recurrences and metastasis, which may increase chances of mortality in the patient.