국립암센터 / 이성욱, 김대용*
Abstract
BACKGROUND:
To analyze the causes and patterns of unexplained carcinoembryonic antigen (CEA) elevation after curative treatment in locally advanced rectal cancer patients.
METHODS:
Among the 1309 locally advanced rectal cancer patients treated with curative resection and radiotherapy between January 2001 and June 2011, 325 patients who postoperatively developed abnormal CEA elevation were reviewed. The unexplained CEA elevation was defined as a CEA level higher than 5 ng/mL with no evidence of cancer recurrence at the time of elevation.
RESULTS:
Of the 325 patients, 143 (44%) had unexplained CEA elevations. The causes were categorized as delayed recurrence (n = 29, 20%), non-colorectal malignancy (n = 10, 7%), and non-malignancy-related conditions (n = 104, 73%). Shorter intervals between treatment and the first CEA elevation, and a higher peak CEA level, were observed in the delayed recurrence group compared with the non-colorectal malignancy or non-malignancy-related group (intervals of 6.8 vs. 44.9 vs. 23.2 months, respectively, p = 0.002; and peak CEA levels of 9.9 vs. 7.1 vs. 6.2 ng/mL, respectively, p = 0.034). In patients who showed delayed recurrence, the interval between the first CEA elevation and diagnosis of recurrence was a median of 13.0 months (range 3.8-60.6 months). Smoking was the most common cause for non-malignancy-related conditions. The patterns of unexplained CEA elevations were defined as sporadic (n = 78, 55%), stationary (n = 37, 26%), and increasing (n = 28, 20%). The patterns were significantly different depending on the cause (p < 0.001).
CONCLUSIONS:
Analysis of the patterns of unexplained CEA elevations is a reasonable approach to predict the cause of the cancer.
Author information
Lee SU1, Jwa E1, Kim DY2, Kim TH1, Baek JY1, Cha Y1, Chang HJ1, Oh JH1.
1
Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea.
2
Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea. radiopia@ncc.re.kr.
편집위원
임상적으로 종종 접하게 되는, 설명되지 않는 CEA 상승의 원인을 분석한 논문
2018-12-14 16:46:47