Correlation Between Tumor Cell Differentiation and CEA Levels in Patients with Adenocarcinoma of the Rectum

Abstract

Adenocarcinoma of the rectum is the most common colorectal cancer in Indonesia. This cancer has the highest recurrence after curative surgical therapy with or without adjuvant therapy. With the advancing modern histopathology and molecular biology, the prognosis after therapy can be predicted through surveillance using tumor cell differentiation and carcinoembryonic antigen (CEA). The aim of this study was to analyze the correlation between tumor cell differentiation and serum CEA level in patients with adenocarcinoma of the rectum in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This was a retrospective observational analytic study conducted from January 2018- January 2019. There were 36 patients involved in this study consisting of 3 patients (8.3%) diagnosed with Stage II, 10 patients (27.7%) with Stage IIIA, 20 patients (55.5%) with stage IIIB, and 3 patients (8.3%) with stage IIIC. On histopathological examination, it was demonstrated that19 patients (52.8%) were well-differentiated, 15 patients (41.7%) were moderately differentiated, and 2 patients (5.6%) were poorly differentiated. The mean CEA level (CI 95%) for well-differentiated patients before surgery was 138.18 (15.99-260.38) ng/ml while the same level for the moderately differentiated patients was 64.34 (34.34-163.02) ng/ml. The mean CEA level for poorly differentiated patients was 1.55 (6.71-9.81) ng / ml. The result of the Kruskal Wallis test showed a p-value of 0.004. There is a strong correlation between the level of tumor cell differentiation and CEA level.

Keywords

• adenocarcinoma of the rectum, carcinoembryonic antigen (cea), tumor cell differentiation