Carcinoembryonic Antigen in the Diagnosis and Management of Colorectal Carcinoma

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Abstract
Carcinoembryonic antigen (CEA) titers were determined in 137 patients with proven colorectal carcinoma preoperatively, and at routine intervals following operation. Preoperatively 65% of all patients had a positive test. The assay was positive in 14% with Dukes stage A tumors, 54% with B, 60% with C, and 79% with stage D lesions. Regional differences were noted with right-sided colon lesions having circulating CEA less frequently than left-sided colon tumors. The titer of CEA did not correlate directly either with the size or stage of the tumor, although marked elevations usually indicated metastatic disease. In patients with curative resections, CEA levels usually reverted to negative postoperatively, but became elevated again with recurrence of disease. Titers remained elevated in patients with D lesions who underwent palliative resection.