Entre los primeros estarían la mayoría de los MT más conocidos: antígeno carcinoembrionario (CEA), alfa-fetoproteína (AFP), antígeno prostático específico . Introdução: O antígeno carcinoembrionário, CEA é o marcador tumoral mais usado em pacientes com câncer colorretal, principalmente no acompanhamento . O que é considerado valor alto num exame de antigeno carcinoembriogenico( cea)?. Uma esofagite pode elevar CEA? Uma esofagite pode elevar CEA?.
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CEA as a prognostic index in colorectal caecinoembriogenico. The carcinoembryonic antigen, CEA, is the tumor marker most used in colorectal patients, principally during follow up after radical surgery. High serum CEA level before surgery is often associated with worse prognosis, in some studies. The purpose of this study was to evaluate the preoperative carcinoembryonic antigen levels CEA and the frequency of recurrence.
Eighty-three patients with colorectal cancer at Dukes stages A, B or C were evaluated retrospectively. The patients’ follow up was at least two years or to death. Disease recurrence was observed in 32 patients Although the tumor stage is today the most valuable prognostic variable in colorectal cancer, the preoperative CEA value can provide some additional information in the prognosis of the patient.
Colorectal cancer is one of the most common cancers in industrialized cities.
In Brazil, it is the 4th largest cause of cancer in women and the 6th in men. Inpersons had colorectal cancer and died from this cancer in this country.
Serum carcinoembriogdnico of CEA is the the most widely used tumor marker in these patients. The main function of this marker is to detect early recurrence during follow up after radical surgery.
The serum dosage of CEA at diagnosis has low sensitivity because patients with colorectal cancer can have normal levels of serum CEA. The relationship between high CEA serum levels in the antiteno period and worse prognosis has been investigated in several studies 2,3,4,5so carcinoembriogenkco without definite conclusion.
Patients with high CEA serum levels before cqrcinoembriogenico could have a higher incidence of recurrence than patients with normal levels. The aim of this study was to retrospectively evaluate the serum CEA levels before surgery in operable colorectal cancer patients as a predictor of recurrence. The possible relationships between serum levels of CEA and sex, age, diameters of the tumor, histological diffentiation, tumor site colon or rectum and Dukes stage have also been evaluated.
The mean age of the patients was 57 years yearsthere being 42 women and 41 men.
All had operable cancer. All the patients were followed for at least two years or up to death. We calculated the sensitivity, specificity and positive and negative predictive value for CEA as an index of tumor recurrence.
CEA as a prognostic index in colorectal cancer
Statistical analysis consisted of Kruskal-Wallys analysis of variance or Chi square test. CEA levels were elevated in 7 of the 12 patients who developed liver metastases. Before the completion of 1 year of follow up, 12 patients had relapsed. Among the 32 patients with recurrence of the disease during the follow up, 16 had preoperative elevated CEA serum levels and 16 had normal CEA levels. The sensitivity, specificity, the positive predictive value and the negative predictive value are described in Table 5.
Thirty years after its description by Gold and Freedman 1the CEA remains the tumor marker most studied in colorectal cancer, its main function being the monitoring of patients after the surgical resection of the tumor.
“antígeno carcinoembrionario” in English
The preoperative CEA level as a prognostic index is not yet defined, although many authors believe that the CEA level offers an additional criterion for evaluating the prognosis of colorectal cancer. As in the majority of previous studies 2,4we also did not observed any differences of CEA levels when comparing sex, age, tumor site, tumor diameter or histological differentiation.
The mean serum levels were higher for tumors in Dukes stage C than for stages B or A. The differences in serum CEA were statistically significant. We observed, as in previous studies, that This percentage was higher in the patients with nodal involvement Dukes C. The sensitivity was lower than in the studies of Wang 9 and Tate 10 but similar to McCall In the group of patients with elevated preoperative CEA and recurrence, this occurred in the first year of follow up.
Chu 7 and Groslin 3 also reported that patients with elevated CEA level had recurrence after the first 6 months. Northover 13 reported that the risk of recurrent disease within two years of primary surgery was more than double in those whose serum CEA was raised preoperatively.
In these patients the recurrence would be more frequently in the first year of follow up. The results from this series are consistent with several published works. Although the information provided by the tumor stage is still the most valuable prognostic variable today, the preoperative elevated CEA level provides additional information on the prospects for survival, suggesting a more aggressive tumor and probably identifying a subgroup of patients for adjuvant therapy.
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