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Original Article
The Clinical Significance of Carcinoembryonic Antigen and CA72-4 Assays of Peritoneal Fluid in Colorectal Carcinomas.
Park, Jong Dae , Kim, Hee Cheol , Cho, Young Kyu , Yu, Chang Sik , Kim, Jin Cheon
Journal of the Korean Society of Coloproctology 2002;18(5):330-336

Colorectal Clinic, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. jckim@www.amc.seoul.kr
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PURPOSE
CEA and CA72-4 assays in peritoneal fluid offers the greatest advantage in increasing the sensitivity of cytologic diagnosis of carcinomas of the G-I tract. Actually, little investigations have been taken for the relations between CEA and CA72-4 levels in peritoneal fluid and the clinicopathologic characteristics of colorectal carcinomas. The intent of this study was to verify the usefulness of CEA and CA72-4 levels in peritoneal fluid for the treatment of colorectal carcinoma.
METHODS
Seventy-three colorectal cancer patients who were hospitalized in our colorectal division were prospectively investigated. Thirty-five out of 73 patients had ascites. Preoperatively, the levels of serum CEA and CA72-4 were measured. At the time of laparotomy, ascites or peritoneal washings were collected from all patients and the levels of carcinoembryonic antigen and CA72-4 were measured and submitted for the analysis to the cytology laboratory. We analyzed the results with the levels of serum CEA and CA72-4, histologic differentiation, location, stage of the tumor, and obstruction due to tumor.
RESULTS
The levels of serum CEA and CA72-4 were significantly correlated with those of peritoneal fluid. The elevated levels of CEA and CA72-4 of peritoneal fluid were also significantly correlated with advanced stages of colorectal carcinomas, respectively. But according to histologic differentiation, only CA72-4 levels of peritoneal fluid were elevated in poorly differentiated or mucinous carcinoma. No difference between the levels of CEA and CA72-4 of peritoneal fluid was present in accordance with the location of tumors.
CONCLUSIONS
The measurement of CEA and CA72-4 of peritoneal fluid may be valuable method in discriminating between the early-stage versus the late-stage colorectal carcinoma.


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