Cutoff value of the preoperative serum carcinoembryonic antigen in the liver metastasis in colorectal cancerMeilyna Sulphiana Alam, Warsinggih Warsinggih, Prihantono Prihantono, Bambang Suprapto.
Objective: To analyze the association between the elevation in preoperative serum carcinoembryonic antigen (CEA) levels and the incidence of liver metastasis in colorectal cancer (CRC) patients. In this study, the authors tried to determine the cutoff value of the preoperative serum CEA in the liver metastasis CRC.
Methods: A total of 142 patients with histologically diagnosed CRC were obtained from patients medical records from 2015 to 2017, which met the research subject criteria. The variables were analyzed and included preoperative serum CEA in CRC patients with and without liver metastasis based on CT abdomen contrast at the time of initial diagnosis.
Results: We found 41 patients (28.9%) with liver metastasis and 101 patients (71.1%) without metastasis. Serum CEA values (median and mean) in subjects with liver metastasis (28.7 and 28.9 ng/ml) were significantly higher than in subjects without metastasis (5.7 ng/ml and 7.1 ng/ml) (p < 0.001). The preoperative serum CEA level of > 5 ng/ml significantly increases in the risk of liver metastasis. The calculation of the area under the curve (AUC) showed a value of 0.824 (82.4%) with a significant p-value (p < 0.001), and a cutoff CEA level of 12.0 ng/ml provides ideal diagnostic value (balanced sensitivity and specificity) to predict liver metastasis with the highest accuracy of 85.2%.
Conclusion: The preoperative serum CEA levels were significantly increased in CRC with liver metastasis and can be used as a good biomarker to predict the presence of liver metastasis in CRC.
Key words: Colorectal cancer, carcinoembryonic antigen, liver metastases