Carcinoembryonic Antigen in the Diagnosis and Management of Colorectal Cancer Patients with Liver Metastasis

Abstract

Thirty-four colorectal cancer patients with liver metastasis (synchronous 20 cases, recurrent 14 cases were examined), and the usefulness and limitations of the determination of carcinoembryonic antigen (CEA) values were investigated. Among 20 cases of synchronous liver metastasis, elevated CEA values were found in 70%. In eight of these cases, CEA values were determined serially before and after resection of the cancer. In cases with preoperative elevated CEA values, CEA increased with enlargement in postoperative liver metastasis, but in cases with preoperative normal CEA values, the postoperative CEA levels changed only a little in some, while they increased in others. Among 14 cases of liver recurrence, elevated CEA values were found in 92.9%. In six of these cases, CEA levels were measured before and after recurrence. CEA showed abnormal values three to 10 months (six months on the average) before the detection of liver recurrence. Furthermore, the increase was rapid. Serial measurement of CEA levels in colorectal cancer patients was useful in the observation of the course of liver metastatis, the judgment of therapeutic effect, and the detection of liver recurrence. However, CEA values can be normal in the presence of obvious liver metastasis, and it is important to know both their usefulness and limitations.