Prognostic factor of serum carcinoembryonic antigen in colorectal cancer patients: a follow up study

Abstract

Colorectal cancer is a serious cancer with high mortality. Most of the recurrence usually occurred within two years after surgery. This study was conducted in Nineveh Medical Center and Al-Jammhorri Hospital to evaluate colorectal cancer patients in a follow up study for two years. Serum carcinoembryonic antigen, colonoscopy, ultrasound of the abdomen, and chest X rays were used for evaluation. One hundred and ninety-four patients with colorectal cancer were included in the study. The patients were diagnosed colorectal adenocarcinomas by histopathology and staged according to Duke’s classification. The patients were undergone surgical removal of the cancer. Chemotherapy was started to the patient after two weeks of the surgery. Blood samples were taken one week before and one week after surgery. Other blood samples were taken after chemotherapy and then every six months for two years. The blood samples were analyzed for serum carcinoembryonic antigen. The patients were also checked by colonoscopy, ultrasound for abdomen, and chest X ray every six months. Serum carcinoembryonic antigen in colorectal patients was higher than 5 ng/mL and decreased significantly after surgery but still higher than 5 ng/mL. After chemotherapy serum decreased significantly compared with that after surgery. During the two-year period serum carcinoembryonic antigen was not significantly different from that in patients after chemotherapy. Twenty-one patients died after two years of the study Serum carcinoembryonic antigen in the dead patients was much significantly higher than 5 ng/mL before surgery and decreased significantly after operation and after chemotherapy but still higher than 5 ng/mL. In conclusion, colorectal cancer is a significant disease in Iraq. The mortality rate is high due to lack of education of the community to that disease. Carcinoembryonic antigen marker is still acceptable test but should be used with other clinical assessments