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Prognostic Value of CEA and CA 19-9 Tumor Markers Combined with Cytology from Peritoneal Fluid in Colorectal Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Early diagnosis and management of peritoneal metastases from colorectal cancer patients are difficult clinical challenges. The aims of this study were to evaluate the clinical significance of tumor markers and cytology in peritoneal effusions (PE) and peritoneal irrigation fluid (PI) and to determine their value as prognostic indicators in this disease.

Methods

Two hundred thirty-four consecutive patients who underwent abdominal surgery for colorectal cancer from January 2006 to December 2007 were included, and tumor markers and cytology in PE and PI were analyzed prospectively.

Results

The incidence of free cancer cells retrieved from peritoneal samples was 7.9%. Cytology was positive in 40.0% by Papanicolaou and Giemsa staining, 73.3% by hematoxylin and eosin staining of cell blocks, and 66.7% by carcinoembryonic antigen (CEA) and calretinin immunohistochemistry. Multivariate analysis revealed that peritoneal CEA and cancer antigen (CA) 19–9 in PI were correlated with peritoneal metastasis and cytology. Level of peritoneal fluid CEA was statistically significantly correlated with recurrence and peritoneal metastatic recurrence in patients with negative peritoneal cytology. Cytology, peritoneal CEA, and peritoneal CA 19-9 showed correlations with cancer-free survival and overall survival.

Conclusions

These correlations demonstrate the importance of continuous follow-up of peritoneal metastasis if there is positive cytology or an increase in CEA and CA 19-9 in peritoneal fluid.

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Acknowledgments

I.K.L. was supported by CJ-Aventis New Research Grant from Korean Society of Coloproctology and a grant from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (A080760).

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Authors and Affiliations

  1. Department of Surgery, St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 150-713, Korea

    In Kyu Lee MD, Do Hyoung Kim MD, Yoon Suk Lee MD, Hyung Jin Kim MD, Won Kyung Kang MD, Jong Kyung Park MD, Chang Hyeok Ahn MD, Jun-Gi Kim MD, Hae Myung Jeon MD & Seong Taek Oh MD

  2. Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA

    In Kyu Lee MD & D. Lee Gorden MD

  3. Department of Education and Research, National Health Insurance Corporation Ilsan Hospital, Goyang-si, Gyeunggi-do, Korea

    Na Young Sung MS

  4. Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Gyeoung-Sin Park MD

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  1. In Kyu Lee MD
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  2. Do Hyoung Kim MD
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  3. D. Lee Gorden MD
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  4. Yoon Suk Lee MD
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  13. Seong Taek Oh MD
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Corresponding authors

Correspondence to In Kyu Lee MD or Seong Taek Oh MD.

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Lee, I.K., Kim, D.H., Gorden, D.L. et al. Prognostic Value of CEA and CA 19-9 Tumor Markers Combined with Cytology from Peritoneal Fluid in Colorectal Cancer. Ann Surg Oncol 16, 861–870 (2009). https://doi.org/10.1245/s10434-008-0294-3

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  • DOI: https://doi.org/10.1245/s10434-008-0294-3

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