결직장암 간전이 진단 시 혈청 암배아항원의 임상적 의의 (Clinical Significance of Serum Carcinoembryonic Antigen (CEA) Level at Diagnosis of Liver Metastases in Patients with Colorectal Cancer)

서지정보

· 발행기관 : 대한대장항문학회
· 수록지 정보 : Annals of Coloproctolgy / 24권 / 6호 / 439 ~ 446페이지
· 저자명 : 남정수, 신진용, 김경하, 박정익, 김운원, 최창수, 최영길, 홍관희

초록

Purpose: In numerous clinical trials to stratify prognosis
of patients with liver metastases (LM) from colorectal
cancer (CRC), the clinical value of serum carcinoembryonic
antigen (CEA) levels at diagnosis of LM has not
been fully investigated in these group. The aim of this
study is to explore the relation of CEA to characteristics
of LM and to analyze prognostic value of this widely used
tool. Methods: We retrospectively analyzed clinical data
of 143 LM patients who were performed surgical intervention
or non-surgical intervention. The cohort was divided
into two groups; normal CEA group (NCEAG, ＜5
ng/ml, n=41) and elevated CEA group (ECEAG, ≥5
ng/ml, n=102). We examined correlation between serum
CEA at diagnosis of LM and other clinicopathologic factors
and performed univariate and multivariate analyses to determine
the clinical impact of this marker on survival.
Results: Compared to ECEAG, the characteristics of LM
of NCEAG was associated with unilobar distribution of
LM (P=0.003), less metastases (P＜0.001), less rate of
synchronocity (P=0.008) and more surgical intervention
of hepatic deposits (P＜0.001). The 5-year survival rate
for NCEAG was better than ECEAG (P=0.031). Multivariate
analysis revealed that the presence of lymphatic
duct invasion, no performance of chemotherapy, bilobar
distribution of LM, and treatment of non-surgical intervention
had a significant effect on survival. CEA elevation
was identified as independently associated with bilobar
distribution and non-surgical intervention of LM.
Conclusions: Although CEA level is not a independent
prognostic factor in this study, the clinical characteristics
identified in this study and correlation to non surgical intervention
of LM may help better patient selection in the
management of CRC LM patients.

영어초록

Purpose: In numerous clinical trials to stratify prognosis
of patients with liver metastases (LM) from colorectal
cancer (CRC), the clinical value of serum carcinoembryonic
antigen (CEA) levels at diagnosis of LM has not
been fully investigated in these group. The aim of this
study is to explore the relation of CEA to characteristics
of LM and to analyze prognostic value of this widely used
tool. Methods: We retrospectively analyzed clinical data
of 143 LM patients who were performed surgical intervention
or non-surgical intervention. The cohort was divided
into two groups; normal CEA group (NCEAG, ＜5
ng/ml, n=41) and elevated CEA group (ECEAG, ≥5
ng/ml, n=102). We examined correlation between serum
CEA at diagnosis of LM and other clinicopathologic factors
and performed univariate and multivariate analyses to determine
the clinical impact of this marker on survival.
Results: Compared to ECEAG, the characteristics of LM
of NCEAG was associated with unilobar distribution of
LM (P=0.003), less metastases (P＜0.001), less rate of
synchronocity (P=0.008) and more surgical intervention
of hepatic deposits (P＜0.001). The 5-year survival rate
for NCEAG was better than ECEAG (P=0.031). Multivariate
analysis revealed that the presence of lymphatic
duct invasion, no performance of chemotherapy, bilobar
distribution of LM, and treatment of non-surgical intervention
had a significant effect on survival. CEA elevation
was identified as independently associated with bilobar
distribution and non-surgical intervention of LM.
Conclusions: Although CEA level is not a independent
prognostic factor in this study, the clinical characteristics
identified in this study and correlation to non surgical intervention
of LM may help better patient selection in the
management of CRC LM patients.

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