대장암 근치수술에서 수술 전후 혈청 암태아성 항원의 의의
The Significance of Perioperative Serum Carcinoembryonic Antigen Measurement in Patients with Curative Colorectal Cancer
조영규, 남궁환, 홍현기, 유장학, 김정랑, 김희철, 유창식, 김진천,
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조영규 ( Cho Young-Kyu )
울산대학교 의과대학 외과학교실
남궁환 ( Namgung Hwan )
울산대학교 의과대학 외과학교실
홍현기 ( Hong Hyun-Ki )
울산대학교 의과대학 외과학교실
유장학 ( Yoo Jang-Hak )
울산대학교 의과대학 외과학교실
김정랑 ( Kim Jung-Rang )
울산대학교 의과대학 외과학교실
김희철 ( Kim Hee-Cheol )
울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik )
울산대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon )
울산대학교 의과대학 외과학교실
KMID : 0356720020180030190
Abstract
Purpose: Regular monitoring of serum carcinoembryonic antigen (CEA) has been used as a tool to detect recurrence of colorectal cancer postoperatively. This study aimed to evaluate the significance of perioperative serum CEA level in patients with curative colorectal cancer.
Methods: We analyzed the data obtained from the 420 patients with colorectal cancer who underwent curative resection. Preoperative serum CEA level (ng/㎖) was divided into 3 groups, i.e. groups Ⅰ: ≤6, Ⅱ: 6∼20, Ⅲ: ≥20. Each group of preoperative serum CEA level was analyzed in accordance with location, histologic differentiation, stage of tumor, recurrence and survival. Postoperative serum CEA level was analyzed in accordance with preoperative serum CEA level and recurrence.
Results: Preoperative serum CEA level correlated with tumor stage (P=0.009). Ninety six patients among 420 patients showed recurred and recurrences were more common in patients with high preoperative serum CEA level (P=0.002). Systemic recurrences were more common in patients with high preoperative serum CEA levels than normal levels (P=0.029). In recurrence cases, 75 patients (78.1%) had elevated serum CEA levels and 55 patients had high preoperative serum CEA levels (P=0.008). The disease free 5-year survival rate in preoperative serum CEA group Ⅰ, Ⅱ, and Ⅲ were 91.4%, 70.5%, and 58.3% respectively (P=0.000)
Conclusions: Preoperative serum CEA levels seemed to be closely correlated with distant metastasis and survival. Meticulous follow-up evaluation and generous use of adjuvant therapy are recommanded in patients with high preoperative CEA level.
키워드
암태아성 항원;재발;전이;대장암
Carcinoembryonic antigen (CEA);Recurrence;Metastasis;Colorectal cancer
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