Giá trị tiên lượng của nồng độ CEA huyết thanh sau phẫu thuật ung thư đại tràng giai đoạn II–III

Colon cancer remains a significant global health challenge, characterized by high morbidity and mortality. For patients diagnosed with stage II-III colon cancer, the standard of care involves curative surgical resection followed by adjuvant chemotherapy. Accurate prognostication is paramount for guiding treatment strategies and monitoring disease progression. Carcinoembryonic antigen (CEA) is a well-established tumor marker for colorectal cancer, with its levels often correlating with disease activity. While preoperative CEA can indicate tumor burden, persistently elevated postoperative CEA has been strongly associated with an increased risk of disease recurrence and poorer prognosis. This study aims to investigate the relationship between perioperative serum CEA levels and clinicopathological characteristics, and critically evaluate the prognostic value of postoperative CEA in predicting disease progression in stage II-III colon cancer patients.

Oncologists, surgeons, researchers in gastrointestinal oncology, and medical professionals involved in the management of colorectal cancer.

This study comprehensively investigated the prognostic utility of serum carcinoembryonic antigen (CEA) levels in patients with stage II-III colon cancer undergoing curative resection and adjuvant chemotherapy. The primary objective was to determine the association between perioperative CEA levels and clinicopathological characteristics, and to evaluate the prognostic value of postoperative CEA in predicting disease progression. A retrospective cohort study was conducted on 141 patients treated at K Hospital between December 2023 and August 2025. Serum CEA levels were assessed preoperatively and approximately four weeks (3-12 weeks) postoperatively, followed by an analysis of their correlation with patient outcomes. The findings revealed that the majority of patients (80.1%) presented with elevated preoperative CEA levels (>5 ng/mL). Crucially, postoperative CEA levels showed a significant decrease, normalizing in most cases. However, persistently elevated postoperative CEA levels (>5 ng/mL) were identified as a strong, independent predictor of early disease progression, increasing the risk 2.5-fold compared to patients with normalized levels (OR = 2.515; 95% CI: 1.026–6.167; p = 0.044). This underscores that while curative surgery is effective, continuous monitoring of CEA is vital. The normalization of serum CEA after surgery indicates successful tumor removal, but sustained high levels serve as a critical alarm for potential residual disease or early recurrence. These results strongly advocate for the routine monitoring of postoperative CEA as a reliable and cost-effective tool for risk stratification, enabling clinicians to identify high-risk patients for early intervention and personalize adjuvant chemotherapy strategies, thereby improving patient management and outcomes in stage II-III colon cancer.