A Clinical Study on the Significance of CEA Levels in Gallbladder Bile from Patients with Colorectal Cancer

Takanori Shimura, Masaru Suzuki, Tsuyoshi Tsukamoto, Masao Sanada, Masaru Miyazaki*, Akira Togawa*

Department of Surgery, Chiba Rosai Hospital
*The First Department of Surgery, Chiba University School of Medicine

It has been reported that gallbladder bile CEA levels could represent a sensitive index for the detection of occult hepatic metastases in patients with colorectal cancer. However, the mechanism of elevation of gallbladder bile CEA levels or the result of a follow-up study has not been fully clarified. In this study, the clinical value of gallbladder bile CEA measurement in patients with colorectal cancer was evaluated in regard to these problems. Gallbladder bile CEA levels in patients with liver metastasis were significantly higher than those in aptients without it (1182.9±1624.7 vs 34.8±69.9 ng/ml, p<0.05). As a result of our follow-up study, the incidence of liver metastasis in patients with elevated gallbladder bile CEA levels more than 60 ng/ml was found to be significantly higher than those in patients with gallbladder bile CEA levels less than 60 ng/ml (42.9% vs 8%, p<0.05). There was a close correlation between the gallbladder bile CEA level and the grade of CEA stain in a metastatic liver lesion. In conclusion, we confirm that patients with elevation of gallbladder bile CEA levels (>60 ng/ml) may be candidates for occult hepatic metastases, and suspect that elevation of gallbladder bile CEA levels in patients with liver metastasis is mainly due to direct secretion into the bile of CEA produced by the metastatic liver lesion.

Key words
colorectal cancer, liver metastasis, CEA, gallbladder bile

Reprint requests
Takanori Shimura Department of Surgery, Chiba Rosai Hospital
2-16 Tatsumidai Higashi, Ichihara, 290 JAPAN

Accepted
September 11, 1996

To read the PDF file you will need Abobe Reader installed on your computer.