Role of serum carcinoembryonic antigen level in predicting relapse of colorectal cancer after radical surgery

Objective To study the correlation of serum carcinoembryonic antigen（CEA） level with the prognosis and relapse of colorectal cancer（CRC） after operation. Methods A total of 464 consecutive patients with CRC after radical surgery included in this study were retrospectively analyzed.Cox multivariate regression model was used to observe independent predicting factors for the prognosis of CRC.Receiver operating characteristic curve（ROC） was used to evaluate the cutoff value of S-CEA level as a predicting factor for the prognosis of CRC. Results Multivariate analysis showed that elevated CEA level before operation was the independent predicting factor for the relapse of CRC（P=0.01）.The cutoff value of CEA level（4.1μg/L） in ⅢB stage CRC patients before operation was found to be a predicting factor for the prognosis of CRC,with a sensitivity of 69% and a specificity of 80%.The CEA level was elevated in 36.6% patients with local recurrence,in 66.7% patients with single organ metastasis,and in 75.0% in patients with multi-organ metastasis,respectively,after operation. Conclusion Preoperative serum CEA level is a reliable predictive factor for the recurrence of CRC after radical operation.As a predicting factor for the relapse and prognosis of CRC,the cutoff value of serum CEA level may be used as a diagnostic index different from the current diagnostic criteria for CRC.CEA test provides a method for the early detection of relapse,especially distant metastasis of CRC.