[Measurement of bile CEA levels in patients with colorectal cancer: is it of value for diagnosis of occult liver metastases aiming at prophylactic regional hepatic chemotherapy?].

A preliminary study was conducted to determine whether the measurement of CEA levels in gallbladder bile would be of value for diagnosis of occult liver metastases aiming at prophylactic regional hepatic chemotherapy in patients with colorectal cancer. Forty-fold dilution by normal human sera was necessary to measure CEA levels of gallbladder bile by the enzyme immunoassay (EIA). Bile CEA levels were 27.2 +/- 30.4 (M +/- SD) ng/ml in patients with benign biliary diseases (control), 248.5 +/- 426.3 ng/ml (p < 0.05, vs. control) in Dukes B, C patients, and 3,331.5 +/- 4,473.3 ng/ml (p < 0.01 vs. control, p < 0.05 vs. Dukes B, C) in patients with hepatic metastases from colorectal cancer, respectively. Bile CEA tended to demonstrate the existence of hepatic metastases more accurately than serum CEA. Our results obtained from a small number of patients suggest that patients with either elevation of bile CEA level or with a high ratio of bile CEA/serum CEA may be candidates for hepatic recurrence that requires prophylactic hepatic chemotherapy. However, it may be difficult to determine the bile CEA level at which occult liver metastases are demonstrated.