Predictive value of plasma CEA levels

Abstract

Plasma CEA [carcinoembryonic antigen] levels were determined in 280 patients with histologically proven colorectal carcinoma: in 180 once or twice preoperatively and repeatedly postoperatively, and in 100 postoperatively only. Preoperative levels correlated directly with the surgical-pathologic state and inversely with the time of recurrence; i.e., groups of patients with a more advanced stage showed a higher proportion of elevated CEA levels, and patients with a higher levels had recurrences earlier. Levels above 20 ng/ml were strongly suggestive of liver metastases or disseminated disease. Postoperative plasma CEA levels displayed 3 patterns of variation. Levels fluctuating within normal range, below 3.2 ng/ml, strongly evidenced that surgery was effective, and those fluctuating below 7.5 ng/ml usually indicated nonmalignant concomitant disease; in either group no more than 10% of the patients had recurrences. Levels rising persistently from a postoperative nadir indicated recurrence or, when the rise was dramatic, liver metastases or disseminated cancer in at least 97% of the patients.