转移性结直肠癌患者化疗后血清癌胚抗原水平的变化

目的:观察转移性结直肠癌病人化疗前后血清癌胚抗原(CEA)水平的变化及临床意义。方法:对施行过化疗的转移性结直肠癌病人进行回顾性研究,采用CEA试剂盒以微粒子化学发光免疫分析法测定血清CEA水平,研究CEA的变化及其与一些临床特征之间的关系。结果:67例转移性结直肠癌患者中19例(28.4%)化疗开始后70天内血清CEA有所升高,71天～210天期间再复查时,其CEA水平又降至化疗前水平或更低。影像学检查提示这19例CEA短暂升高的病人均从化疗之中得到益处(11例PR,8例SD)。没有证据支持CEA短暂升高与肿瘤原发部位、肿瘤转移、肿瘤分化之间有明确的关联。结论:某些转移性结直肠癌病人化疗开始后的血清CEA水平可以有一短暂的升高,可能与临床受益有关,尚不能作为肿瘤进展的指征。

The transient CEA elevation induced by chemotherapy in patients with metastatic colorectal cancer

Objective:To investigate the level of carcinoembryonic antigen(CEA)before and after chemotherapy and to assess its clinical significance in patients with metastatic colorectal cancer(MCRC).Methods:A retrospective review of patients with MCRC treated with chemotherapy was conducted.The serum CEA level was detected by automated microparticle chemiluminescent immunoassay method with CEA kit.The incidence of transient CEA clevation and its association with several clinical characteristics was investigated.Results:Sixty seven patients were evaluable for CEA change.The serum CEA level was increased for a period(about 70 days)in 19 patients(28.4%)after initiation of chemotherapy,then decreased to the level of prechemotherapy or even lower level.All the 19 patients of transient CEA elevations had radiographic evidence of beneit from chemotherapy(11 had partial responses and 8 stable disease).No significant correlation was noted between such transient CEA elevation and site of primary tumor,site of metastatic disease,or tumor differentiation.Conclusion:A transient and returnable elevation of CEA can be observed in some patients with MCRC after initiation of chemotherapy and is associated with a clinical benefit.The transient CEA elevation after initiation of chemotherapy cannot be used as an indicator of progressive disease.