Korean J Gastroenterol.  2018 Jun;71(6):332-337. 10.4166/kjg.2018.71.6.332.

Diagnostic Value of Carcinoembryonic Antigen in Ascites for Colorectal Cancer with Peritoneal Carcinomatosis

Affiliations
  • 1Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea. parksj6406@daum.net

Abstract

BACKGROUND/AIMS
Diagnostic tests for carcinoembryonic antigen (CEA) in ascites have been performed in various malignant cases, but there is only few data on the applicability of CEA for colorectal cancer (CRC) patients with peritoneal carcinomatosis. We aimed to determine the usefulness of CEA in ascites (aCEA) as a diagnostic parameter for CRC with peritoneal carcinomatosis.
METHODS
Between January 2000 and May 2013, the medical records of 259 patients who underwent paracentesis for the evaluation of ascites were retrospectively reviewed. CRC patients with ascites (n=82) and patients with non-malignant ascites (n=177) were evaluated. Patients who had other malignancies, including gastric or ovarian cancer, with ascites were excluded. The optimal diagnostic cut-off value of aCEA for CRC with peritoneal carcinomatosis was determined using receiver operating characteristic curve analysis. The value of aCEA for predicting the occurrence of peritoneal carcinomatosis was evaluated using a logistic regression model.
RESULTS
The optimal cut-off value of aCEA to diagnose CRC with peritoneal carcinomatosis was 3.89 ng/mL, and the area under the curve for aCEA was 0.996 (sensitivity 96.3%, specificity 100%, positive predictive value 100%, negative predictive value 98.3%). Multivariate logistic regression analysis showed that aCEA was an independent factor predicting the occurrence of peritoneal carcinomatosis.
CONCLUSIONS
In this study, we showed that aCEA may be a useful parameter for diagnosing CRC with peritoneal carcinomatosis, and we propose an optimal aCEA cut-off value of 3.89 ng/mL. Further study that includes patients with other malignant ascites may be necessary to validate these findings.

Keyword

Carcinoembryonic antigen; Ascites; Peritoneal neoplasms; Colorectal neoplasms

MeSH Terms

Ascites*
Carcinoembryonic Antigen*
Carcinoma*
Colorectal Neoplasms*
Diagnostic Tests, Routine
Humans
Logistic Models
Medical Records
Ovarian Neoplasms
Paracentesis
Peritoneal Neoplasms
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Carcinoembryonic Antigen

Figure

  • Fig. 1. Levels of aCEA in the benign and CRC groups. aCEA, carcinoembryonic antigen in ascites; CRC, colorectal cancer.

  • Fig. 2. ROC curve of diagnostic parameters. ROC, receiver operating characteristic; aCEA, carcinoembryonic antigen in ascites; sCEA, serum carcinoembryonic antigen.


Cited by  1 articles

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Jieun Yun, Sang-Bae Han, Hong Jun Kim, Se-il Go, Won Sup Lee, Woo Kyun Bae, Sang-Hee Cho, Eun-Kee Song, Ok-Jun Lee, Hee Kyung Kim, Yaewon Yang, Jihyun Kwon, Hee Bok Chae, Ki Hyeong Lee, Hye Sook Han
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