Comparison of CEA Level Among Tumor Location and Histopathological Findings in Colorectal Cancer
Zain, Lukman Hakim
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Carcinoembryonic antigen (CEA) is one of the most widely used tumor markers, especially in colorectal malignancy. The purpose of this study was to investigate comparison of CEA levels among tumor location, histopathological findings, and correlation with routine blood test and body mass index (BMI). Methods: Cross-sectional study on sixty-five consecutive colorectal patients admitted to Adam Malik General Hospital Medan, Indonesia from November 2015–April 2016, which diagnosed by histopathology examination and were classified pathologically according to the degree of malignant cell differentiation into well differentiated, moderately differentiated, poorly differentiated, undifferentiated, and others. Serum samples were obtained to determine routine blood test and CEA level. Spearman Correlation and ANOVA test were used for univariate and bivariate statistical analysis. Results and Discussions: There were 61.5%, 23.1%, 15.4% patients with rectal cancer, left-sided colon cancer, and right-sided colon cancer, respectively. There were 38.5% biopsy tissues with well differentiated, 21.5% moderately differentiated, 15.4% poorly differentiated, 9.2% undifferentiated, and 15.4% others. There were no correlation between CEA level with level of haemoglobin, leucocyte, hematocrit, platelet, ureum, creatinine, and random blood glucose. There was significant negative correlation between CEA level and body mass index (r = ˗0.35, p = 0.005). There was no significant difference in CEA level among tumor location, but CEA level was significantly different among histopathological findings (p = 0.048). The level of CEA showed significant increase in poorly differentiated than well differentiated (p = 0.036). Meanwhile, Ng et al. found that preoperative CEA was higher in tumors showing moderate and poor differentiation, although it did not reach statistical significance (p = 0.068). Conclusion: CEA showed statistically significant difference among the degree of malignant cell differentiation.