Patterns of serum CEA levels in different clinico-pathological variables of colorectal cancer

Background: Globally, colorectal malignancy is the 3rd most frequent cancer and the 2nd major cause of mortality. Serum carcinoembryonic antigen (CEA) is a simple tumor marker for the diagnosis, predicting response to therapy and survival and identifying the recurrence of colorectal cancer. Therefore, the aim was to evaluate the pattern of serum CEA levels in patients with colorectal cancer presenting at a tertiary care hospital in Karachi Patients and methods: It was a cross-sectional study conducted at the Department of Medical Oncology of Jinnah Postgraduate Medical Center, Karachi from January till August 2019. One ninety-nine patients of 12-80 years age and either gender diagnosed with colorectal cancer (biopsy-proven) were included. Data on demographics, clinical and pathological findings were recorded in the pre-designed proforma. The serum CEA levels in colorectal cancer patients were assessed using an ELISA kit. CEA levels higher than 5.0 ng/mL were deemed as elevated CEA levels in colorectal patients. Data were analyzed using SPSS version 23. Results: A total of 191 colorectal cancer patients were included. The mean age of the patients was 42.81±15.22 years. Most of the patients (61.3%) were male. Out of 191 colorectal cancer patients, 60 (31.4%) had CEA level 0-0.3 ng/ml, whereas 79 (41.4%) had elevated serum CEA level (>10 ng/ml). The CEA levels were stratified with respect to effect modifiers. The size of the tumor, TNM staging and localization and metastasis of cancer showed a statistically significant difference between levels of CEA (p<0.05). Conclusion: The raised CEA levels are associated with clinically progressive or presence of residual and recurrent disease. For patients with progressive tumors, particularly colorectal carcinoma, CEA assays are an important guide to assess the burden of the tumor, hence clinicians and surgeons ought to monitor antigen levels. It is recommended to enhance the clinical efficacy of the CEA levels.