Significance of Carcinoembryonic Antigen (CEA) levels in colorectal carcinoma

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer and the fourth most common cancer cause of death globally. Though it is relatively less common in Indian sub-continent, but now a days it is also identified as an important heath problem in Bangladesh. Objectives: To find out the clinico-demographic Characteristics of colorectal carcinoma. Methods: This descriptive cross-sectional study was conducted among 72 patients with colorectal carcinoma confirmed by histopathology attending at the department of Surgery, Rajshahi Medical College during the period of January 2009 to December 2010. Data regarding patient's age & gender, information about the tumour like, anatomic subsite, diameter, staging, histological pattern, and preoperative serum Carcinoembryonic Antigen (CEA) level were collected by a pretested questionnaire. Fisher exact probability test and One Way ANOVA test were applied to verify the associations among the variables. Results: A total of 72 CRC patients, 32 ((44.4%) patients had rectal, 27 (37.5%) had right colon and the rest 13 (18.1%) had left colon carcinoma. Male and female ratio among the study subjects was 2.6:1. Highest incidence (23, 31.9%) of the carcinoma was in the 30-39 years age group. Of the study subjects, 12 (16.7%) cases were Dukes' stage A (stage 1), 16 (22.22%) were Dukes' stages B (stage II), 30 (41.66%) were Dukes' stage C (stage III) and 14 (19.44%) cases were Dukes' stage D (stage IV). Out of 72 cases, 63 (87.5%) cases had elevated preoperative CEA serum levels (>5ng/ml). Preoperative elevated CEA levels was significantly associated (p<0.05) with Dukes' stage of the carcinoma. The mean preoperative CEA serum level was significantly differed with the degree of tumor differentiation (p<0.001) Conclusion: Preoperative serum CEA level 5 ng/ml should not be used as a single screening test for colorectal carcinoma. Preoperative serum CEA concentration>5ng/ml correlating with the signs and symptoms of CRC may be used in multiphasic screening of CRC for further confirmation.