결직장암 간전이 진단 시 혈청 암배아항원의 임상적 의의
Clinical Significance of Serum Carcinoembryonic Antigen (CEA) Level at Diagnosis of Liver Metastases in Patients with Colorectal Cancer
남정수, 신진용, 김경하, 박정익, 김운원, 최창수, 최영길, 홍관희,
소속 상세정보
남정수 ( Nam Jeong-Su )
인제대학교 의과대학 외과학교실
신진용 ( Shin Jin-Yong )
인제대학교 의과대학 부산백병원 외과학교실
김경하 ( Kim Kyung-Ha )
인제대학교 의과대학 부산백병원 외과학교실
박정익 ( Park Jeong-Ik )
인제대학교 의과대학 부산백병원 외과학교실
김운원 ( Kim Woon-Won )
인제대학교 의과대학 부산백병원 외과학교실
최창수 ( Choi Chang-Soo )
인제대학교 의과대학 부산백병원 외과학교실
최영길 ( Choi Young-Kil )
인제대학교 의과대학 부산백병원 외과학교실
홍관희 ( Hong Kwan-Hee )
인제대학교 의과대학 부산백병원 외과학교실
KMID : 0356720080240060439
Abstract
Purpose: In numerous clinical trials to stratify prognosis of patients with liver metastases (LM) from colorectal cancer (CRC), the clinical value of serum carcinoembryonic antigen (CEA) levels at diagnosis of LM has not been fully investigated in these group. The aim of this study is to explore the relation of CEA to characteristics of LM and to analyze prognostic value of this widely used tool.
Methods: We retrospectively analyzed clinical data of 143 LM patients who were performed surgical intervention or non-surgical intervention. The cohort was divided into two groups; normal CEA group (NCEAG, ＜5ng/ml, n=41) and elevated CEA group (ECEAG, ≥5 ng/ml, n=102). We examined correlation between serum CEA at diagnosis of LM and other clinicopathologic factors and performed univariate and multivariate analyses to determine the clinical impact of this marker on survival.
Results: Compared to ECEAG, the characteristics of LM of NCEAG was associated with unilobar distribution of LM (P=0.003), less metastases (P＜0.001), less rate of synchronocity (P=0.008) and more surgical intervention of hepatic deposits (P＜0.001). The 5-year survival rate for NCEAG was better than ECEAG (P=0.031). Multivariate analysis revealed that the presence of lymphatic duct invasion, no performance of chemotherapy, bilobar distribution of LM, and treatment of non-surgical intervention had a significant effect on survival. CEA elevation was identified as independently associated with bilobar distribution and non-surgical intervention of LM.
Conclusions: Although CEA level is not a independent prognostic factor in this study, the clinical characteristics identified in this study and correlation to non surgical intervention of LM may help better patient selection in the management of CRC LM patients.
키워드
간전이;암배아항원;예후
Liver metastasis;Carcinoembryonic antigen;Prognosis
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