PURPOSE: Carcinoembryonic antigen (CEA) determination in gallbladder bile was used in a prospective study concerning the morphological and clinical features of the neoplasm and the occurrence of hepatic metastasis. METHODS: CEA levels in the gallbladder and peripheral blood were studied in 44 patients with colorectal carcinoma and 10 patients with uncomplicated cholelithiasis from samples collected immediately before extirpating the colorectal neoplasms or cholecystectomy (values of up to 5 ng/ml were considered normal). RESULTS: In the 44 patients with colorectal carcinoma who underwent operation with curative intent, the average level of serum CEA was 8.5 ng/ml and for bile CEA, 74.5 ng/ml. In the patients with uncomplicated cholelithiasis who underwent cholecystectomy, the average level of serum CEA was 1.9 ng/ml and for bile CEA, 1.2 ng/ml. Four patients who underwent extirpation of the colorectal carcinoma without evidence of hepatic metastasis and with an average bile CEA value of 213.2 ng/ml presented hepatic metastasis between three and seventeen months after removal of the neoplasms. CONCLUSION: The high CEA levels in gallbladders of patients undergoing curative operation for colorectal carcinoma may indicate the presence of hepatic metastasis. Such patients must be followed up with special attention to the diagnosis of such lesions.
Carcinoembryonic antigen; Colorectal neoplasms; Neoplasm metastasis
