術前血清CEA値別にみた大腸癌術後再発に関する検討 Clinicopathological Study on Colorectal Cancer with Recurrence after Curative Surgery According to the Serum Levels of CEA

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大腸癌術後フォローアップにおける術前血清CEA値および術後血清CEA値測定の適切な利用法について検討した.対象は13年間に経験した根治度Aの手術を施行しえた大腸癌のうち,術前血清CEA基準値以下で再発した79例(基準値再発例)と術前血清CEA基準値より高値で再発した65例(高値再発例)で,これらを臨床病理学的項目,再発部位,再発の発見契機,再発に対する治療法および治療成績について比較検討した.肝再発の54.8%(23例/42例)で定期的な血清CEA値測定が再発発見に有用で,再発例の切除率も50%と高率であったことから血清CEA値測定は肝再発のサーベイランスに有用と考えられた.肺再発では術前血清CEA値高値例の57.9%(11例/19例)で再発発見に血清CEA値測定は有用であったが,切除率は21.1%,5年生存率は0%と低率で,治療成績向上には定期的な画像診断が必要で,局所再発では症状や所見の変化に注意を払うことが重要と考えられた.<br>

This study investigated the significance of pre- and postoperative serum CEA level in monitoring colorectal cancer after surgery. The study included 144 colorectal cancer patients with recurrence after curative surgery. Of these, 65 patients with high serum CEA level before surgery (high group) were clinicopathologically compared with 79 patients with serum CEA level within the normal limit (normal group). Hepatic recurrence was detected in 55% of cases by postoperative regular check of serum CEA level and operation was performed in 50% of these cases. Lung recurrence in the high group was found in 58% of cases by postoperative regular check of serum CEA level, but operation was performed in only 21.1% of them. As a result, none of them survived more than 5 years. Local recurrence was found in 56% of cases by symptoms. The regular check of serum CEA level was useful for detection in only 21% of local recurrence cases. Regular check of serum CEA level was thought to be useful in monitoring and detecting hepatic recurrence. It is thought to be important to examine symptoms/signs and to perform regular examinations in monitoring lung and local recurrence.<br>

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  • 日本大腸肛門病学会雑誌  

    日本大腸肛門病学会雑誌 61(7), 396-403, 2008-07-01 

    The Japan Society of Coloproctology

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