engleski

Prognostic and therapeutic score for colorectal adenomas and the role of serum and tissue carcinoembrionic antigen (CEA)

The colorectal adenomas as precursors to the development of colorectal cancer have great scientific and clinical importance. The serum (S CEA) and tissue (T CEA) concentrations of carcinoembryonic antigen in 56 colorectal adenomas with regard to multiplicity, diameter, pathohistological finding (tubular adenomas, tubulovillous adenomas and villous adenomas), and degree of dysplasia (mild, moderate, severe, adenoma with invasive adenocarcinoma) were studied.T CEA was measured using the CEA-EIA method (Abbott) modified for wet tissue and was obtained from the head of the polyp (T CEA-A), margin of resection at the neck and base of the polyp, respectively (T CEA-B), mucosa near the polyp (T CEA-C) and rectal mucosa (T CEA-D). The M-estimators and Mann-Whitney U test were used to differentiate CEA distribution between various classes of adenomas within each characterisation. S CEA has shown a statistically significant correlation with the adenoma diameter, but no significant correlation with regard to the multiplicity, pathohistological finding and degree of dysplasia was found. T CEA from the head of the polyp (T CEA-A) demonstrated highly significant difference between mild and severe dysplasia, between mild dysplasia and invasive adenocarcinoma and between mild and moderate dysplasia. T CEA from the neck and base of the polyp, respectively, mucosa near the polyp, and mucosa of the rectum revealed no significant difference with respect to dysplasia. The pathohistological type of the adenoma has also influenced T CEA. There was a statistically significant difference in T CEA-A between tubular and villous adenomas. T CEA differentiated changes within an adenoma alone and in the surrounding tissue from those in the rectal mucosa. On the basis of six adenoma characteristics (multiplicity, diameter, pathohistological finding, degree of dysplasia, S CEA and T CEA), we are proposing a new score for the evaluation of adenoma malignant transformation as a guideline for the choice of therapy and clinical follow-up.

prognostic score; therapeutic score; colorectal adenomas; tissue carcinoembrionic antigen; serum carcinoembrionic antigen; evaluation of adenoma malignant transformation; degree of dysplasia

nije evidentirano