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대장직장암 환자의 수술전 후 혈장내 CEA치의 임상적 의의

Clinical Value of Pre- and Post-operative Serum Carcinoembryonic Antigen(CEA) in Colorectal Cancel

대한대장항문학회지 1997년 13권 4호 p.573 ~ 582
윤영욱 ( Yun Young-Wook ) - 전북대학교 의과대학 외과학교실

유희철 ( Yu Hee-Chul ) - 전북대학교 의과대학 외과학교실
김종훈 ( Kim Jong-Hun ) - 전북대학교 의과대학 외과학교실
황용 ( Hwang Yong ) - 전북대학교 의과대학 외과학교실

Abstract


The clinical value of the pre-(165 pts) and post-operative(149 pts) serum levels of carcinoembryogenic antigen(CEA) in 190 patients(pts) with colorectal cancer was investigated, who had a curative surgery and an abnormally elevated levels of CEA (> or=5 ng/ml) at Department of General Surgery, Chonbuk National University Hospital during 1989 to 1996.
The results are as follows: 1) The preoperative positive rates of CEA level were 49(29.7%) of 165 patients, so preoperative CEA level measurement was no usefulness for screening test of colorectal cancer. The incidence of preoperatively elevated CEA levels in Dukes stages A, B, C, and D were 0, 28.6, 32.8 and 42.9% respectively, There was significant association between increased proportion of patients with preopertive serum CEA(≥ 5 ng/ml) and the progressive stages of colorectal cancers(P<0.05). 2) There was no significant association between the frequency of abnormal CEA level
and histologic differentiation of tumor. 3) The recurrence rate was 16.4% and 30.6% in patients with preoperative CEA < 5
ng/ml and ≥5 ng/ml, respectively(p<0.05). 4) In patients with recurrence, the lymph node positive group(70.6%) was larger than the negative(29.4%)(p<0.05), and preoperative positive rate of CEA value was 44% . 5) The recurrence rate in Dukes stages A, Bl, B2, Cl, C2, and D were 0, 8.7, 12.7, 16.7, 32.3, and 90.0% respectively(p<0.01). 6) There was no significant association between the frequency of abnormal CEA level and location of tumor. 7) The recurrence rate was 12.3% and 65.7% in patients with postoperative CEA < 5 ng/ml and ≥ 5 ng/ml, respectively(p<0.01). 8) In patients with metastasis, postoperative positive rate of CEA level was 63%(p< 0.01).

키워드

Carcinoembryonic Antigen(CEA)
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