1199 Carcinoembryonic antigen testing in colorectal cancer follow-up: a study of patients' attitudes and preferences

Background: Several prognostic factors were proposed to improve early detection of recurrence after liver resection of metastases of colorectal cancer. Circulating tumor cell-related transcripts were evaluated in colorectal cancer patients with conflicting results. The aim of this study was to investigate usefulness of carcinoembryonic antigen CAM5, epidermal growth factor receptor, and ERCC1 transcripts in the bloodstream as predictive factors of recurrence in patients who underwent liver resection for metastases of colorectal cancer. Methods: Peripheral blood was collected from 29 patients at the time of the colorectal cancer liver metastasis resection, and from 25 normal controls. Follow-up draws (FUDs) were also performed at 30 days, and 3 and 12 months since surgery. On each sample, carcinoembryonic antigen CAM5, ERCC1, and GAPDH mRNAs were examined by quantitative reverse transcription (qRT). Results: Carcinoembryonic antigen transcript levels were linearly correlated to the number of spiked cells (qRT analytical limit = five cells). Among 29 patients (20 M/9 F; mean age 63 years (range 32–79), highly significant levels of carcinoembryonic antigen, if compared to the baseline, were detected in those relapsing after surgery ( P <0.05). The main differences were between the 1st- and 12th-month FUDs. Significantly higher levels of carcinoembryonic antigen were also detected in patients who died from disease progression during the follow-up (as evaluated at 30 days and 90 days FUDs). Conclusions: Blood carcinoembryonic antigen-mRNA absolute copy number overtime variation can represent a valid early predictor of relapse after liver resection in colorectal liver metastases patients. Prospective studies, in the context of large clinical trials, will provide further data to also qualify ERCC1 as a predictive biomarker for decisions on therapeutic strategies.

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Surveillance with Serial Serum Carcinoembryonic Levels Detect Colorectal Cancer Recurrences in Patients who are Initial Nonsecretors

The American Surgeon ◽

10.1177/000313481007601017 ◽

2010 ◽

Vol 76 (10) ◽

pp. 1100-1103 ◽

Cited By ~ 4

Author(s):

Alicia Holt ◽

Rebecca A. Nelson ◽

Lily Lai

Keyword(s):

Colorectal Cancer ◽

Carcinoembryonic Antigen ◽

Retrospective Review ◽

Stage I ◽

Recurrent Colorectal Cancer ◽

Serum Carcinoembryonic Antigen ◽

Serial Serum ◽

Resected Stage ◽

Initial Resection

Serum carcinoembryonic antigen (CEA) levels, elevated in a subgroup of patients with colorectal cancer (CRC) at presentation, are serially followed as part of recommended surveillance after initial resection. The value of following serial CEA levels in patients who initially present with less than or normal levels of CEA (nonsecretors) is controversial. This study sought to determine the use of follow-up CEA levels in nonsecretors. A retrospective review was performed of patients with resected Stage I, II, and III CRC. We excluded patients who did not have a pretreatment CEA level, at least two follow-up CEA levels, or in whom CEA levels did not normalize after resection. The patients were grouped by initial CEA values: CEA 5 ng/mL or less (nonsecretors) and CEA 5 + ng/mL: (secretors). We identified 186 patients with CRC; 146 were initial nonsecretors. We identified 22 patients with recurrent colorectal cancer; 6 were secretors and 16 patients were nonsecretors. In the secretors group, CEA was elevated with recurrence in four (66%) of the patients. In the nonsecretors, CEA was elevated with recurrence in eight (50%) of the patients. In summary, many recurrences of CRC are marked by an elevation of CEA regardless of whether the patients initially presented as secretors or nonsecretors.

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Standardization, specificity, and diagnostic sensitivity of four immunoassays for carcinoembryonic antigen

Clinical Chemistry ◽

10.1093/clinchem/37.2.231 ◽

1991 ◽

Vol 37 (2) ◽

pp. 231-236 ◽

Cited By ~ 13

Author(s):

Ole P Börmer

Keyword(s):

Colorectal Cancer ◽

Monoclonal Antibodies ◽

Carcinoembryonic Antigen ◽

Normal Values ◽

The Other ◽

Reference Limit ◽

Sandwich Type ◽

Reference Preparation ◽

Colorectal Cancer Patients

Abstract Four "sandwich"-type immunoassays for carcinoembryonic antigen (CEA) based on monoclonal antibodies (Abbott CEA-RIA Monoclonal, Pharmacia/Wallac Delfia CEA kit, Roche CEA EIA Duomab 60, and our in-house immunoradiometric assay) were compared for 357 samples from colorectal cancer patients and samples from 48 patients with chronic liver disease or with acute, irrelevant diseases. Relative to a common 5 micrograms/L reference limit, all four assays agreed regarding classification in 92% to 94% of the samples in the colorectal cancer samples, with the Abbott and Roche assays giving slightly more "normal" values. Cross-testing of CEA standards and the 1st International Reference Preparation 73/601 showed that calibration differences could not be eliminated by the use of a common standard. It has been earlier demonstrated that the monoclonal antibodies in the Roche assay have an epitope group specificity slightly different from those of the other three assays. This can explain why the correlations involving the Roche assay were weaker (r = 0.84-0.87) than those obtained with the other assays (r = 0.94-0.97). I conclude that agreement between the assays studied is as good as can be expected when different antibodies are used; nevertheless, consistent discrepancies between assays in several patients still necessitate the use of the same assay during follow-up.

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Cost-effectiveness of a carcinoembryonic antigen (CEA) based follow-up programme for colorectal cancer (the CEA Watch trial)

Colorectal Disease ◽

10.1111/codi.13273 ◽

2016 ◽

Vol 18 (3) ◽

pp. O91-O96 ◽

Cited By ~ 11

Author(s):

C. J. Verberne ◽

T. Wiggers ◽

I. Grossmann ◽

G. H. de Bock ◽

K. M. Vermeulen

Keyword(s):

Colorectal Cancer ◽

Cost Effectiveness ◽

Carcinoembryonic Antigen

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Negative Serum Carcinoembryonic Antigen has Insufficient Accuracy for Excluding Recurrence from Patients with Dukes C Colorectal Cancer: Analysis with Likelihood Ratio and Posttest Probability in a Follow-Up Study

Diseases of the Colon & Rectum ◽

10.1007/s10350-008-9406-1 ◽

2008 ◽

Vol 51 (11) ◽

pp. 1675-1680 ◽

Cited By ~ 27

Author(s):

Masayasu Hara ◽

Yukihide Kanemitsu ◽

Takashi Hirai ◽

Koji Komori ◽

Tomoyuki Kato

Keyword(s):

Colorectal Cancer ◽

Carcinoembryonic Antigen ◽

Likelihood Ratio ◽

Follow Up Study ◽

Serum Carcinoembryonic Antigen ◽

Posttest Probability ◽

Dukes C

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COLONOSCOPY AND CARCINOEMBRYONIC ANTIGEN VARIATIONS

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032014000100014 ◽

2014 ◽

Vol 51 (1) ◽

pp. 69-72 ◽

Cited By ~ 1

Author(s):

Rita G SOUSA ◽

Ana NUNES ◽

Tânia MEIRA ◽

Olga CARREIRA ◽

Ana M PIRES ◽

...

Keyword(s):

Colorectal Cancer ◽

Carcinoembryonic Antigen ◽

Cancer Detection ◽

Blood Levels ◽

Patient Anxiety ◽

Younger Patients ◽

Cancer Tumor ◽

Clinical Meaning ◽

Age Range

Context Colonoscopy is essential for synchronous and metachronous cancer detection. Carcinoembryonic antigen is a colorectal cancer tumor marker, important as a follow-up tool in patients with previous colorectal cancer. False-positive carcinoembryonic antigen elevation results in multiples exams and in patient anxiety. In literature, there is reference to transient carcinoembryonic antigen increase with colonoscopy. Objective To evaluate the influence of bowel preparation and colonoscopy in carcinoembryonic antigen blood levels. Methods We prospectively studied subjects that underwent routine colonoscopy in our institution. Blood samples were collected (1) before bowel cleaning, (2) before colonoscopy and (3) immediately after colonoscopy. Blood carcinoembryonic antigen levels were determined by “Sandwich” immunoassay. The statistical methods used were the paired t-test and ANOVA. Results Thirty-seven patients (22M/15F) were included; age range 28-84 (mean 56 years). Mean carcinoembryonic antigen values were 1.9, 2 and 1.8 for (1), (2) and (3), respectively. An increase in value (2) compared with (1) was observed in 20/37 patients (P = 0.018), mainly in younger patients and in patients requiring more endoluminal interventions. In 29/37 patients, the CEA value decreased from (2) to (3) (P = 1.3x10-7). Conclusions A trend for carcinoembryonic antigen increase after bowel cleaning was observed, especially in younger patients and in patients with more endoluminal interventions, but without clinical meaning.

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