Biliary Level of Carcinoembryonic Antigen after Resection of Pancreatic Cancer -Prediction of Liver Metastasis-

Hirotaka Morishima, Masaaki Nakahara, Shigeru Imabun, Kazushi Kurozumi, Tetsuo Kido, Kazuyasu Nakao and Masahiko Tsujimoto^*

Department of Surgery, ^*Department of Pathology, Osaka Police Hospital

Introduction: We studied the relationship between biliary carcinoembryonic antigen (CEA) and liver metastasis after pancreatic cancer resection. Methods: The biliary level of CEA was examined in 21 patients with pancreatic cancer who underwent radical surgery with curability A and B. Postoperatively, liver metastasis occurred in 13-early metastasis within 6 months of surgery in 6, and late metastasis in 7-and no liver metastasis in 8. Bile was collected through a percutaneous transhepatic biliary drainage (PTBD) tube preoperatively and a retrograde transhepatic biliary drainage (RTBD) tube postoperatively. Results: No significant differences were seen in clinicopathological factors between patients with and without liver metastasis. Preoperative biliary CEA was 41±89 ng/ml in the liver metastasis group and 12±14 ng/ml in the no liver metastasis group. Postoperative biliary CEA in the liver metastasis group was 295±432 ng/ml and 67±62 ng/ml in the nonmetastasis group. Postoperative biliary CEA in the early liver metastasis group (476±572 ng/ml) was significantly higher than in the non liver metastasis group (67±62 ng/ml). Biliary CEA increased markedly on day 28 compared to that on day 14 in the early liver metastasis group. Conclusions: Postoperative biliary CEA is useful in predicting early liver metastasis after radical surgery for pancreatic cancer.

Key words
pancreatic cancer, liver metastasis, biliary CEA, serum CEA

Reprint requests
Hirotaka Morishima Department of Surgery, Otemae Hospital 1-5-34 Otemae, Chuoku, Osaka, 540-0008 JAPAN

Accepted
July 24, 2002

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