Prognostic significance of CEA levels and detection of CEA mRNA in draining venous blood in patients with colorectal cancer

J Surg Oncol. 2006 Jul 1;94(1):3-8. doi: 10.1002/jso.20549.


Background and objectives: The aims of this study were to determine carcinoembryonic antigen (CEA) levels and incidence of tumor cells using the RT-PCR technique in draining venous blood of patients with colorectal cancer, correlate the results with various histopathologic factors and determine their significance as prognostic factors.

Methods: From 1995 to 2000, 108 patients with adenocarcinoma of the colon or rectum, underwent curative surgery and enrolled in this prospective study.

Results: The 5-year survival group had significantly lower portal CEA levels compared to the hepatic metastasis outcome group. CEA mRNA was positive in the draining venous blood from 12 (11.1%) out of 108 patients included in the study. The rate of positive tumor cell detection in portal blood was significantly higher in the hepatic metastasis outcome group than in the 5-year survival and recurrence group. The proportion of patients with portal CEA > or =5 ng/ml was greater in patients with higher stage than in patients with lower stage.

Conclusions: Positive CEA mRNA in draining venous blood predicted hepatic metastases and local recurrence with accuracy over 80% but with low sensitivity of 30% and 9%, respectively. Moreover, CEA level was a sensitive indicator in hepatic metastases as sensitivity was 95% and a specific indicator in predicting 5-year survival with specificity 84%.

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / pathology
  • Biomarkers, Tumor / blood*
  • Biomarkers, Tumor / genetics
  • Carcinoembryonic Antigen / blood*
  • Carcinoembryonic Antigen / genetics*
  • Colonic Neoplasms / diagnosis*
  • Colonic Neoplasms / pathology
  • Humans
  • Neoplasm Staging
  • Portal Vein / immunology
  • Prospective Studies
  • RNA, Messenger / blood
  • RNA, Messenger / isolation & purification
  • Rectal Neoplasms / diagnosis*
  • Rectal Neoplasms / pathology
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Survival Analysis


  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • RNA, Messenger