摘要
AIM： To evaluate the efficacy of postoperative serial assay of carcinoembryonic antigen （CEA） and cytokeratins for the detection of recurrent disease in patients with colorectal adenocarcinoma after radical surgery. METHODS： Between 1993 and 2000, 120 patients with colorectal adenocarcinoma underwent radical surgery in the Department of Surgical Gastroenterology, Federal University of Sao Paulo-Escola Paulista de Medicina, Sao Paulo, Brazil. Periodic postoperative evaluation was performed by assaying markers in peripheral serum, colonoscopy and imaging examination. Presence of CEA was detected using the Delfia^R method with 5 μg/L threshold, and cytokeratins using the LIA-mat TPA-M Prolifigen^R method with 72 U/L threshold. RESULTS： In the first postoperative year, patients without recurrent disease had normal levels of CEA （1.5 ＋ 0.9μg/L） and monoclonal tissue polypeptide antigen-M （TPA-M, 64.4 ± 47.8 U/L）, while patients with recurrences had high levels of CEA （6.9± 9.8 ;μg/L, P 〈 0.01） and TPA-M （192.2 ±328.8 U/L, P 〈 0.05）. During the second postoperative year, patients without tumor recurrence had normal levels of CEA （2.0 ± 1.8μg/L） and TPA-M （50.8±38.4 U/L）, while patients with recurrence had high levels of CEA （66.3 ±130.8 μg/L, P 〈 0.01） and TPA-M （442.7 ± 652.8 U/L, P 〈 0.05）. The mean follow-up time was 22.3 mo. There was recurrence in 23 cases. Five reoperations were performed without achieving radical excision. Rises in tumor marker levels preceded identification of recurrences： CEA in seven （30%） and TPA-M in eleven individuals （48%）. CONCLUSION： Intensive follow-up by serial assay of CEA and cytokeratins allows early detection of colorectal neoplasm recurrence.
瞄准：与颜色在病人为周期性的疾病的察觉评估 carcinoembryonic 抗原(CEA ) 和 cytokeratins 的手术后的连续试金的功效在激进的外科以后的表面的腺癌。方法：在 1993 和 2000 之间，有颜色的 120 个病人表面的腺癌在外科的肠胃病学的部门经历了激进的外科， Sao Paulo-Escola Paulista de Medicina 的联邦大学， Sao Paulo，巴西。周期的手术后的评估被 assaying 标记在外部浆液，结肠镜检查和成像检查执行。CEA 的存在与 72 U/L 阀值用 LIA 地席 TPA-M Prolifigen 方法与 5 microg/L 阀值，和 cytokeratins 用 Delfia 方法被检测。结果：在第一手术后的年里，没有周期性的疾病的病人有 CEA 的正常层次( 1.5 +/- 0.9 microg/L )并且单音的同种细胞的织物多肽 antigen-M ( TPA-M ， 64.4 +/- 47.8 U/L )，当有复发的病人有 CEA 的高水平时( 6.9 +/- 9.8 microg/L ， P < 0.01 )并且 TPA-M ( 192.2 +/- 328.8 U/L ， P < 0.05 )。在第二手术后的年期间，没有肿瘤复发的病人有 CEA 的正常层次( 2.0 +/- 1.8 microg/L )并且 TPA-M ( 50.8 +/- 38.4 U/L )，当有复发的病人有 CEA 的高水平时( 66.3 +/- 130.8 microg/L ， P < 0.01 )并且 TPA-M ( 442.7 +/- 652.8 U/L ， P < 0.05 )。吝啬的后续时间是 22.3 瞬间。在 23 种情况中有复发。没有完成激进的切除，五个手术被动。在肿瘤标记层次的上升先于复发的鉴定：在七的 CEA (30%) 和在十一个个人(48%) 的 TPA-M。结论：由 CEA 和 cytokeratins 的连续试金的集中的后续允许颜色的早察觉表面的瘤复发。
基金
Supported by Foundation for Research Support of the State of Sao Paulo-FAPESP, No. 98/12504-1
