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Rezidivprognosen bei Patienten mit Adenocarcinomen des Gastrointestinaltraktes auf der Basis von Carcinoembryonalem Antigen (CEA) und seinen zirkulierenden Immunkomplexen

Relapse prognosis for patients with adenocarcinoma of the gastrointestinal tract on the basis of carcinoembryonic antigen (CEA) and its circulating immune complexes

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Summary

CEA immune complexes and free CEA were routinely determined in sera of 350 patients with adenocarcinoma of the gastrointestinal tract preoperatively and during a 2-year surveillance period. We could detect circulating CEA immune complexes preoperatively in 25% of our patients. The appearance of CEA immune complexes proved to be a useful prognostic marker with respect to tumor extension since 72/86 patients with CEA immune complexes showed metastasis at the primary resection.

The postoperative appearance of CEA immune complexes could be used as an additional parameter for the diagnosis of the relapse; 32/60 patients with a relapse developed CEA immune complexes during the period of surveillance. All patients with localized disease recurrence were found to be free of CEA immune complexes. Detection of CEA immune complexes, however, coincided always with the clinical diagnosis of distant spread of disease. This diagnosis was always preceded by an increase of free CEA and/or CEA immune complexes. In 5/60 patients the relapse could only be demonstrated by clinical methods since these patients stayed CEA-negative throughout the surveillance period.

Zusammenfassung

CEA-Immunkomplexe wurden neben freiem CEA im Serum von 350 Patienten mit Adenocarcinomen des Gastrointestinaltraktes präoperativ und während einer zweijährigen Überwachung routinemäßig bestimmt. Bei 25% der Patienten (n=86) konnten schon präoperativ zirkulierende CEA-Immunkomplexe nachgewiesen werden. Das Auftreten von CEA-Immunkomplexen erwies sich als geeigneter prognostischer Marker hinsichtlich der Tumorausdehnung, da bei 72/86 Patienten mit CEA-Immunkomplexen Metastasierung bei der Erstoperation vorlag.

Das postoperative Auftreten von CEA-Immunkomplexen konnte als zusätzlicher Parameter für die Rezidivdiagnose herangezogen werden. 32/60 Patienten mit Rezidivierung entwickelten im Verlauf der Überwachung CEA-Immunkomplexe. Alle Patienten mit lokalisierten Rezidiven waren frei von CEA-Immunkomplexen. Wenn dagegen CEA-Immunkomplexe nachgewiesen werden konnten, war klinisch immer eine Fernmetastasierung feststellbar. Dieser Diagnose ging immer ein Anstieg des freien CEA und/oder der CEA-Immunkomplexe voraus. Bei 5/60 Patienten konnte die Rezidivierung nur klinisch gesichert werden, da diese Patienten im Überwachungszeitraum immer CEA-negativ blieben.

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Authors and Affiliations

  1. Friedrich-Miescher-Laboratorium der Max-Planck-Gesellschaft, Tübingen

    H. J. Staab,  F. A. Anderer, E. Stumpf & R. Fischer

  2. Chirurgische Klinik, Stuttgart-Bad Cannstatt

    H. J. Staab,  F. A. Anderer, E. Stumpf & R. Fischer

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  3. E. Stumpf
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  4. R. Fischer
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Staab, H.J., Anderer, F.A., Stumpf, E. et al. Rezidivprognosen bei Patienten mit Adenocarcinomen des Gastrointestinaltraktes auf der Basis von Carcinoembryonalem Antigen (CEA) und seinen zirkulierenden Immunkomplexen. Klin Wochenschr 58, 125–133 (1980). https://doi.org/10.1007/BF01477269

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