Sequential carcinoembryonic antigen (CEA) plasma levels were obtained postoperatively in 181 patients with colorectal Dukes stages B2 and C colorectal cancers to assess their usefulness as part of a follow-up program designed to detect disease progression. In all, 1,684 determinations were obtained in patients who were, at the time, free of any clinical or radiologic evidence of disease. If individual CEA determinations are considered and if 10 ng/ml is specified as the limit between normal and elevated CEA levels, both sensitivity (45.0%) and specificity (93.4%) make determination of CEA levels an acceptable screening test in this well-defined population, especially as it also fulfills the criteria of patient acceptance, potential benefit to the patient, and low cost. Preoperative CEA levels were also determined in 93 of the 181 patients, and these results confirm the prognostic value of the slope between preoperative and postoperative CEA levels.
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