Title: Co-Relation between CEA Level and Different Stages of Colorectal Carcinoma
Authors: Dr Arun Antony, Dr Annu Sajeev, Dr Gejoe.G
DOI: https://dx.doi.org/10.18535/jmscr/v5i12.41
Abstract
Introduction: Colorectal carcinoma is the third most common cancer in men and second in women worldwide. Incidence rates per 100,000 in India for males is 4.3/100000 and for females is 3.4/100000. Levels of various substances in blood can help act as tumor marker for the detection, staging and prognosis of the patients.CEA levels are elevated in 60-90% of patients with colorectal carcinomas. Despite its lack of specificity it can help in making clinical decisions and assessing therapy response.
Aims
1 .To assess if preoperative CEA level an independant indicator of severity of colorectal cancer(as indicated by TNM staging)
- To find out percentage of cases showing elevation of CEA Levels in different stages of colorectal carcinoma
Materials and Methods: We conducted a study on all patients admitted in Department of surgery in Government medical college, Thiruvananthapuram over a period of 20 months with diagnosis of colorectal carcinoma who already had a baseline CEA levels done as a part of workup. Smokers were included in the study but were considered as having high CEA levels only when the level was more than 5ng/ml. Data was entered in structured proforma and correlated with CEA levels and statistically analysed using Chi square test and Mann whitney U test.
Results: Out Of 78 patients studied only 29(37%) had elevated CEA Levels irrespective of the stage of the disease. majority (56%) presented with bleeding per rectum. most common blood group affected was O+ve. CECT detected lesions in 95% cases. Most common histopathological pattern was well differentiated adenocarcinoma. On analysis using Mann Whitney U test it was found that CEA levels rose progressively with the stage of the disease but p-value was found to be 0.066.
Conclusion: From this study it was found that colorectal carcinoma was predominantly a disease of people aged above 50 yrs of age, majority (56%) presented with bleeding per rectum as main symptom and inferred that there is no correlation between CEA levels and different stages of colorectal carcinoma. Hence CEA levels cannot be used to predict the severity of colorectal carcinoma as indicated by TNM Staging.
Keywords: Colorectal carcinoma, CEA (Carcinoembryonic antigen).