Preoperative plasma CEA levels were measured in 502 Patients with colorectal cancer and were examined for clinical significance in disease extent and prognosis. The progress of 261 Patients operated upon for cure of colorectal carcinoma was followed postoperatively with a standardized protocol and significance of plasma CEA level for detection of recurrence, timing of detection and site of recurrence was analysed. The preoperative CEA levels showed normal value(less than 2. 5 ng/ml) in 27. 7% of cases, however, it showed relatively good correlation with disease extent, resectability, histologic differentiation, survival and disease free survival, significant difference of which were noted between lower than 5 ng/ml group and 5 ng/ml or higher group. TVhen the upper limit for CEA of 5 ng/ml was allowed, sensitivity, specificity and pre- dictive value for recurrence were 78.3%, 89.3% and 80% respectively. Median interval between CEA elevation and clinical recurrence was 2.1 months. Site of recurrence-locore- gional or distant-was correlated with CEA level at recurrence.
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