The value of serum carcinoembryonic antigen in predicting recurrent disease following curative resection of colorectal cancer

Abstract

CEA was the first indicator of recurrent disease in 58 percent of all patients and in 80 percent of patients with liver metastases. The diagnosis of recurrent disease may be made several months earlier by investigating the first abnormal CEA level, although any benefit in terms of survival remains to be proven.

A prospective study comparing multi-gene biomarker chip and serum carcinoembryonic antigen in the postoperative surveillance for patients with stage I–III colorectal cancer

“…In the literature, the estimated sensitivity of serum CEA for detecting relapsed disease in patients with completely resected CRC is 58%-89%, with a 1.5-6.0-month lead time between serum CEA level elevation and recurrence detection [26][27][28][29]. In the present study, the sensitivity and specificity of elevated serum CEA level detection were 60.4% and 83.2%, with a median lead time of 2.8 months between serum CEA level and relapse detection, consistent with the previous reports.…”

“…However, the sensitivity and specificity of relapse detection depends largely on the definition of elevated serum CEA levels (cutoff value). The higher the cutoff value for the elevated serum CEA levels is, the higher (lower) the specificity (sensitivity) would be [27,30]. Elevated preoperative serum CEA levels indicate a poor prognosis and are correlated with a reduced OS after surgical resection [27,[31][32].…”

“…The higher the cutoff value for the elevated serum CEA levels is, the higher (lower) the specificity (sensitivity) would be [27,30]. Elevated preoperative serum CEA levels indicate a poor prognosis and are correlated with a reduced OS after surgical resection [27,[31][32]. In the present study, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of elevated preoperative serum CEA levels for predicting postoperative relapse were 54.1%, 71.2%, 26.5%, 89.0%, and 68.5%, respectively.…”

Correlation of CEA but not CA 19-9 as serum biomarkers of disease activity in a case of metastatic rectal adenocarcinoma

“…19,22 This tumor marker is often the earliest indicator of recurrence, preceding clinical and radiographic evidence in 3-quarters of cases. [9][10][11][12] As a result, current ASCO guidelines recommend that CEA measurements be routinely obtained at 3 month intervals during postoperative surveillance and at 1-3 month intervals during systemic treatment for metastatic CRC. 23 The value of monitoring CA 19-9, on the other hand, is more controversial.…”

“…Persistent elevation of CEA after surgery suggests the presence of residual disease and portends a poor prognosis. 8,9 Similarly, repeat elevation of CEA in a patient with an initially positive serologic response to treatment is highly suggestive of recurrent disease [9][10][11][12] and often warrants further investigation if verified to be significantly elevated and/or consistently rising.…”