Cancer Research and Treatment

Original Articles

Carcinoembryonic Antigen Improves the Performance of Magnetic Resonance Imaging in the Prediction of Pathologic Response after Neoadjuvant Chemoradiation for Patients with Rectal Cancer: Gyu Sang Yoo, Hee Chul Park, Jeong Il Yu, Doo Ho Choi, Won Kyung Cho, Young Suk Park, Joon Oh Park, Ho Yeong Lim, Won Ki Kang, Woo Yong Lee, Hee Cheol Kim, Seong Hyeon Yun, Yong Beom Cho, Yoon Ah Park, Kyoung Doo Song, Seok-Hyung Kim, Sang Yun Ha; Cancer Res Treat. 2020;52(2):446-454. Published online September 25, 2019; DOI: https://doi.org/10.4143/crt.2019.261

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Purpose
The purpose of this study was to investigate the role of carcinoembryonic antigen (CEA) levels in improving the performance of magnetic resonance imaging (MRI) for the prediction of pathologic response after the neoadjuvant chemoradiation (NCRT) for patients with rectal cancer.
Materials and Methods
We retrospectively reviewed the medical records of 524 rectal cancer patients who underwent NCRT and total mesorectal excision between January 2009 and December 2014. The performances of MRI with or without CEA parameters (initial CEA and CEA dynamics) for prediction of pathologic tumor response grade (pTRG) were compared by receiver-operating characteristic analysis with DeLong’s method. Cox regression was used to identify the independent factors associated to pTRG and disease-free survival (DFS) after NCRT.
Results
The median follow-up was 64.0 months (range, 3.0 to 113.0 months). On multivariate analysis, poor tumor regression grade on MRI (mrTRG; p < 0.001), initial CEA (p < 0.001) and the mesorectal fascia involvement on MRI before NCRT (mrMFI; p=0.054) showed association with poor pTRG. The mrTRG plus CEA parameters showed significantly improved performances in the prediction of pTRG than mrTRG alone. All of mrTRG, mrMFI, and initial CEA were also identified as independent factors associated with DFS. The initial CEA further discriminated DFS in the subgroups with good mrTRG or that without mrMFI.
Conclusion
The CEA parameters significantly improved the performance of MRI in the prediction of pTRG after NCRT for patients with rectal cancer. The DFS was further discriminated by initial CEA level in the groups with favorable MRI parameters.

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Clinical outcomes of neoadjuvant chemoradiotherapy followed by total mesorectal excision in locally advanced rectal cancer with mesorectal fascia involvement
Jeong Ha Lee, Nalee Kim, Jeong Il Yu, Gyu Sang Yoo, Hee Chul Park, Woo-Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jung Kyong Shin, Joon Oh Park, Seung Tae Kim, Young Suk Park, Jeeyun Lee, Won Ki Kang
Radiation Oncology Journal.2024; 42(2): 130. CrossRef
Predicting the response to neoadjuvant chemoradiation for rectal cancer using nomograms based on MRI tumour regression grade
S. Qin, Y. Chen, K. Liu, Y. Li, Y. Zhou, W. Zhao, P. Xin, Q. Wang, S. Lu, H. Wang, N. Lang
Cancer/Radiothérapie.2024; 28(4): 341. CrossRef
Body composition parameters combined with blood biomarkers and magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Jianguo Yang, Qican Deng, Zhenzhou Chen, Yajun Chen, Zhongxue Fu
Frontiers in Oncology.2023;[Epub] CrossRef
Pretreatment blood biomarkers combined with magnetic resonance imaging predict responses to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Xinyu Shi, Min Zhao, Bo Shi, Guoliang Chen, Huihui Yao, Junjie Chen, Daiwei Wan, Wen Gu, Songbing He
Frontiers in Oncology.2022;[Epub] CrossRef
Clinical implication and management of rectal cancer with clinically suspicious lateral pelvic lymph node metastasis: A radiation oncologist’s perspective
Gyu Sang Yoo, Hee Chul Park, Jeong Il Yu
Frontiers in Oncology.2022;[Epub] CrossRef
High-Resolution T2-Weighted MRI to Evaluate Rectal Cancer: Why Variations Matter
Kirsten L Gormly
Korean Journal of Radiology.2021; 22(9): 1475. CrossRef
MRI Assessment of Complete Response to Preoperative Chemoradiation Therapy for Rectal Cancer: 2020 Guide for Practice from the Korean Society of Abdominal Radiology
Seong Ho Park, Seung Hyun Cho, Sang Hyun Choi, Jong Keon Jang, Min Ju Kim, Seung Ho Kim, Joon Seok Lim, Sung Kyoung Moon, Ji Hoon Park, Nieun Seo
Korean Journal of Radiology.2020; 21(7): 812. CrossRef

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Clinical Significance of Discordance between Carcinoembryonic Antigen Levels and RECIST in Metastatic Colorectal Cancer: In-Ho Kim, Ji Eun Lee, Ji Hyun Yang, Joon Won Jeong, Sangmi Ro, Seong Taek Oh, Jun-Gi Kim, Moon Hyung Choi, Myung Ah Lee; Cancer Res Treat. 2018;50(1):283-292. Published online May 8, 2017; DOI: https://doi.org/10.4143/crt.2016.537

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Purpose
The purpose of this study was to investigate the prognostic implications of carcinoembryonic antigen (CEA) levels that are inconsistent with Response Evaluation Criteria in Solid Tumor (RECIST) responses in metastatic colorectal cancer patients.
Materials and Methods
We retrospectively evaluated 360 patients with at least one measurable lesion who received first-line palliative chemotherapy. CEA-response was defined as CEA-complete response (CR; CEA normalization), CEA-partial response (PR; ≥ 50% decrease in CEA levels), CEA-progressive disease (PD; ≥ 50% increase in CEA levels), and CEA-stable disease (SD; non-CR/PR/PD). Overall survival (OS) and progression-free survival (PFS) were evaluated according to CEA-response.
Results
In RECIST-PR patients, poorer CEA-response was associated with disease progression at the subsequent evaluation. In RECIST-SD patients, CEA-CR and -PR were associated with lower disease progression rates than CEA-PD at the subsequent evaluation. Correlations between survival outcome and CEA-response in same-category RECIST patients were assessed. In RECIST-PR patients, discordant CEA-response (CEA-PD/SD) was associated with poorer survival than CEA-CR/PR (median OS and PFS, 44.0 and 15.4 [CEA-CR], 28.9 and 12.5 [CEA-PR], 21.0 and 9.8 [CEA-SD], and 13.0 and 7.0 [CEA-PD] months, respectively; all p < 0.001). In RECIST-SD patients, favorable CEA-response produced better survival (median OS and PFS, 26.8 and 21.0 [CEA-CR], 21.0 and 11.0 [CEA-PR], 16.1 and 8.2 [CEA-SD], and 12.2 and 6.0 [CEA-PD] months, respectively; all p < 0.001). RECIST-PD patients with CEA-CR showed longer OS than those with CEA-PD. Multivariate analysis demonstrated that discordant CEA-response is a powerful prognostic factor for RECIST-PR and RECIST-SD patients.
Conclusion
Among patients of the same RECIST-response categories, CEA-response patterns are significantly prognostic and strongly predictive of subsequent evaluation outcomes.

Citations

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Presence of CD44v9-Expressing Cancer Stem Cells in Circulating Tumor Cells and Effects of Carcinoembryonic Antigen Levels on the Prognosis of Colorectal Cancer
Katsuji Sawai, Takanori Goi, Youhei Kimura, Kenji Koneri
Cancers.2024; 16(8): 1556. CrossRef
Dynamic monitoring of carcinoembryonic antigen, CA19-9 and inflammation-based indices in patients with advanced colorectal cancer undergoing chemotherapy
Nebojsa Manojlovic, Goran Savic, Bojan Nikolic, Nemanja Rancic
World Journal of Clinical Cases.2022; 10(3): 899. CrossRef
Current Applications and Discoveries Related to the Membrane Components of Circulating Tumor Cells and Extracellular Vesicles
Luis Enrique Cortés-Hernández, Zahra Eslami-S, Bruno Costa-Silva, Catherine Alix-Panabières
Cells.2021; 10(9): 2221. CrossRef
Tumor-Associated Macrophages Derived TGF-β‒Induced Epithelial to Mesenchymal Transition in Colorectal Cancer Cells through Smad2,3-4/Snail Signaling Pathway
Jianhui Cai, Limin Xia, Jinlei Li, Shichang Ni, Huayu Song, Xiangbin Wu
Cancer Research and Treatment.2019; 51(1): 252. CrossRef

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CA19-9 or CEA Decline after the First Cycle of Treatment Predicts Survival in Advanced Biliary Tract Cancer Patients Treated with S-1 and Cisplatin Chemotherapy: Dae-Won Lee, Seock-Ah Im, Yu Jung Kim, Yaewon Yang, Jiyoung Rhee, Im Il Na, Kyung-Hun Lee, Tae-Yong Kim, Sae-Won Han, In Sil Choi, Do-Youn Oh, Jee Hyun Kim, Tae-You Kim, Yung-Jue Bang; Cancer Res Treat. 2017;49(3):807-815. Published online January 18, 2017; DOI: https://doi.org/10.4143/crt.2016.326

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Purpose
While tumor markers (carbohydrate antigen 19-9 [CA 19-9] and carcinoembryonic antigen [CEA]) can aid in the diagnosis of biliary tract cancer, their prognostic role has not been clearly elucidated. Therefore, this study was conducted to evaluate the prognostic role of tumor markers and tumor marker change in patients with advanced biliary tract cancer.
Materials and Methods
Patients with pathologically proven metastatic or relapsed biliary tract cancer who were treated in a phase II trial of first-line S-1 and cisplatin chemotherapy were enrolled. Serum tumor markers were measured at baseline and after the first cycle of chemotherapy.
Results
Among a total of 104 patients, 80 (77%) had elevated baseline tumor markers (69 with CA 19-9 elevation and 40 with CEA). A decline ≥ 30% of the elevated tumor marker level after the first cycle of chemotherapy conferred an improved time to progression (TTP), overall survival (OS), and better chemotherapy response. Multivariate analysis revealed tumor marker decline as an independent positive prognostic factor of TTP (adjusted hazard ratio [HR], 0.44; p=0.003) and OS (adjusted HR, 0.37; p < 0.001). Subgroup analysis revealed similar results in each group of patients with CA 19-9 elevation and CEA elevation. In addition, elevated baseline CEA was associated with poor survival in both univariate and multivariate analysis.
Conclusion
Tumor marker decline was associated with improved survival in biliary tract cancer. Measuring tumor marker after the first cycle of chemotherapy can be used as an early assessment of treatment outcome.

Citations

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Clinical epidemiology of gallbladder cancer in North-Central India and association of immunological markers, NLR, MLR and PLR in the diagnostic/prognostic prediction of GBC
Jyotsna Singh, Durgesh Shukla, Sanjiv Gupta, Braj Raj Shrivastav, Pramod Kumar Tiwari
Cancer Treatment and Research Communications.2021; 28: 100431. CrossRef
Neoadjuvant Intraperitoneal Chemotherapy in Patients with Pseudomyxoma Peritonei—A Novel Treatment Approach
Aruna Prabhu, Andreas Brandl, Satoshi Wakama, Shouzou Sako, Haruaki Ishibashi, Akiyoshi Mizumoto, Nobuyuki Takao, Kousuke Noguchi, Shunsuke Motoi, Masumi Ichinose, Yang Liu, Yutaka Yonemura
Cancers.2020; 12(8): 2212. CrossRef
Clinical and Translational Research Challenges in Biliary Tract Cancers
Angela Lamarca, Melissa Frizziero, Mairéad G. McNamara, Juan W. Valle
Current Medicinal Chemistry.2020; 27(29): 4756. CrossRef
Therapeutic outcomes and prognostic factors in unresectable gallbladder cancer treated with gemcitabine plus cisplatin
Min su You, Ji Kon Ryu, Young Hoon Choi, Jin Ho Choi, Gunn Huh, Woo Hyun Paik, Sang Hyub Lee, Yong-Tae Kim
BMC Cancer.2019;[Epub] CrossRef
Efficacy of interventional therapy and effect on inflammatory factors in patients with gastric cancer after chemotherapy
Puzhao Wu, Jing Wang
Oncology Letters.2019;[Epub] CrossRef
CA19-9 kinetics during systemic chemotherapy in patients with advanced or recurrent biliary tract cancer
Naminatsu Takahara, Yousuke Nakai, Hiroyuki Isayama, Takashi Sasaki, Kei Saito, Kensaku Noguchi, Tatsunori Suzuki, Tomoka Nakamura, Tatsuya Sato, Kazunaga Ishigaki, Ryunosuke Hakuta, Tsuyoshi Takeda, Rie Uchino, Suguru Mizuno, Hirofumi Kogure, Minoru Tada
Cancer Chemotherapy and Pharmacology.2017; 80(6): 1105. CrossRef

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Prognostic Significance of Serum Carcinoembryonic Antigen Normalization on Survival in Rectal Cancer Treated with Preoperative Chemoradiation: Mi-Joo Chung, Su-Mi Chung, Ji-Yoon Kim, Mi-Ryeong Ryu; Cancer Res Treat. 2013;45(3):186-192. Published online September 30, 2013; DOI: https://doi.org/10.4143/crt.2013.45.3.186

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PURPOSE
The purpose of this retrospective study was to identify factors predictive of survival in rectal cancer patients who received surgery with curative intent after preoperative chemoradiotherapy (CRT).
MATERIALS AND METHODS
Between July 1996 and June 2010, 104 patients underwent surgery for rectal cancer after preoperative CRT. The median dose of radiotherapy was 50.4 Gy (range, 43.2 to 54.4 Gy) for 6 weeks. Chemotherapy was a bolus injection of 5-fluorouracil and leucovorin for the first and last week of radiotherapy (n=84, 77.1%) or capecitabine administered daily during radiotherapy (n=17, 16.3%). Low anterior resection (n=86, 82.7%) or abdominoperineal resection (n=18, 17.3%) was performed at a median 47 days from the end of radiotherapy, and four cycles of adjuvant chemotherapy was administered. The serum carcinoembryonic antigen (CEA) level was checked at initial diagnosis and just before surgery.
RESULTS
After a median follow-up of 48 months (range, 9 to 174 months), 5-year disease free survival (DFS) was 74.5% and 5-year overall survival (OS) was 86.4%. Down staging of T diagnoses occurred in 32 patients (30.8%) and of N diagnoses in 40 patients (38.5%). The CEA change from initial diagnosis to pre-surgery (high-high vs. high-normal vs. normal-normal) was a statistically significant prognostic factor for DFS (p=0.012), OS (p=0.002), and distant metastasis free survival (p=0.018) in a multivariate analysis.
CONCLUSION
Patients who achieve normal CEA level by the time of surgery have a more favorable outcome than those who retain a high CEA level after preoperative CRT. The normalization of CEA levels can provide important information about the prognosis in rectal cancer treatment.

Citations

Citations to this article as recorded by

Adenocarcinoma of the colon in children with LAL: A case report
Siham Abbaoui, Najlae Zaari, Abdelouhab Ammor, Houssain Benhaddou
International Journal of Surgery Case Reports.2024; 121: 109995. CrossRef
Comparison of pathological response of standard chemoradiotherapy versus short course radiotherapy in rectal carcinoma: A pilot study
Bangalore Rammohan Nagarjun, Ashini Shah, Amisha Gami, Jahnavi Gandhi, Ankita Parikh, Viraj Modi
Indian Journal of Pathology and Microbiology.2023; 66(4): 708. CrossRef
Can normalized carcinoembryonic antigen following neoadjuvant chemoradiation predict tumour recurrence after curative resection for locally advanced rectal cancer?
Youngki Hong, Amandeep Ghuman, Keat Seong Poh, Dimitri Krizzuk, Arun Nagarajan, Sudha Amarnath, Juan J. Nogueras, Steven D. Wexner, Giovanna DaSilva
Colorectal Disease.2021; 23(6): 1346. CrossRef
Prognostic Impact of Carcinoembryonic Antigen Levels in Rectal Cancer Patients Who Had Received Neoadjuvant Chemoradiotherapy
Jung Il Joo, Sang Woo Lim, Bo Young Oh
Annals of Coloproctology.2021; 37(3): 179. CrossRef
Prognostic significance of elevated pretreatment serum levels of CEA and CA-125 in epithelial ovarian cancer
Yu-Han Lin, Chen-Hsuan Wu, Hung-Chun Fu, Yu-Jen Chen, Yin-Yi Chen, Yu-Che Ou, Hao Lin
Cancer Biomarkers.2020; 28(3): 285. CrossRef
Changes of Microrna Levels in Plasma of Patients with Rectal Cancer during Chemoradiotherapy
Peter Jo, Azadeh Azizian, Junius Salendo, Frank Kramer, Markus Bernhardt, Hendrik Wolff, Jens Gruber, Marian Grade, Tim Beißbarth, B. Ghadimi, Jochen Gaedcke
International Journal of Molecular Sciences.2017; 18(6): 1140. CrossRef
Two case reports
Chang hoon Ahn, Soon Chul Kim
Medicine.2017; 96(46): e8074. CrossRef
Evaluating the Prognostic Role of Elevated Preoperative Carcinoembryonic Antigen Levels in Colon Cancer Patients: Results from the National Cancer Database
Adan Z. Becerra, Christian P. Probst, Mohamedtaki A. Tejani, Christopher T. Aquina, Maynor G. González, Bradley J. Hensley, Katia Noyes, John R. Monson, Fergal J. Fleming
Annals of Surgical Oncology.2016; 23(5): 1554. CrossRef
Prognosis Can Be Predicted More Accurately Using Pre- and Postchemoradiotherapy Carcinoembryonic Antigen Levels Compared to Only Prechemoradiotherapy Carcinoembryonic Antigen Level in Locally Advanced Rectal Cancer Patients Who Received Neoadjuvant Chemor
SooYoon Sung, Seok Hyun Son, Chul Seung Kay, Yoon Suk Lee
Medicine.2016; 95(10): e2965. CrossRef
Can serum dynamics of carcinoembryonic antigen level during neoadjuvant chemoradiotherapy in rectal cancer predict tumor response and recurrence? A multi-institutional retrospective study
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Postoperative carcinoembryonic antigen level has a prognostic value for distant metastasis and survival in rectal cancer patients who receive preoperative chemoradiotherapy and curative surgery: a retrospective multi-institutional analysis
Songmi Jeong, Taek Keun Nam, Jae Uk Jeong, Sung Hwan Kim, Kyubo Kim, Hong Seok Jang, Bae Kwon Jeong, Jong Hoon Lee
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Biomarkers and Molecular Imaging as Predictors of Response to Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer
Chiara Molinari, Federica Matteucci, Paola Caroli, Alessandro Passardi
Clinical Colorectal Cancer.2015; 14(4): 227. CrossRef
Desenlaces del manejo no quirúrgico posterior a neoadyuvancia del cáncer localmente avanzado de recto
Pilar Adriana Torres-Mesa, Ricardo Oliveros, Jorge Mesa, Natalia Olaya, Ricardo Sánchez
Revista Colombiana de Cancerología.2014; 18(3): 109. CrossRef

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Prognostic Significance of Serum and Tissue Carcinoembryonic Antigen in Patients with Gastric Adenocarcinomas: Seong-Hoon Park, Ki-Beom Ku, Ho-Young Chung, Wansik Yu; Cancer Res Treat. 2008;40(1):16-21. Published online March 31, 2008; DOI: https://doi.org/10.4143/crt.2008.40.1.16

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Purpose

Carcinoembryonic antigen (CEA) is known to be elevated in nearly all solid malignancies. The prognostic role of CEA in gastric cancers however, is still controversial. We evaluated preoperative serum CEA levels and CEA expression from the resected tumor tissues to determine whether they have prognostic significance in gastric cancer patients.

Materials and Methods

Medical records of 810 patients who underwent surgery for gastric adenocarcinoma from June, 1998 to February, 2002 in Kyungpook National University Hospital were reviewed. Serum CEA level was evaluated by radioimmunoassay preoperatively, and the cut-off level for positivity was 7.0 ng/ml. Labeled streptavidin-biotin peroxidase method was used to determine CEA expression from the gastric cancer tissues.

Results

Serum and tissue CEA were positive in 9.3% and 91.1% of the patients, respectively. They had no correlation with each other. The positivity rate of serum CEA had positive correlation with invasion depth (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.006), and final stage (p<0.001). Well differentiated tumors showed higher serum CEA positivity (p=0.002). Patients with positive serum CEA had higher recurrence rate (p<0.001). Multivariate analysis showed significantly lower survival rate in patients with preoperative CEA levels over 7 ng/ml than those with lower levels (48.0% vs. 80.7%; p<0.001). The positivity rates of tissue CEA were higher in advanced cancers (p=0.033) and in more advanced stages (p=0.029). Tissue CEA positivity showed no correlation with recurrence or survival.

Conclusions

Preoperative serum CEA level had correlation with disease progression and survival in gastric cancer patients, and proved to be an independent prognostic factor. Tissue CEA expression in gastric cancers had no prognostic information.

Citations

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Case Report

Isolated Diaphragmatic Metastasis Originated from Adenocarcinoma of the Colon: Kang Hong Lee, Chang Sik Yu, Hwan Namgung, Hee Cheol Kim, Jin Cheon Kim; Cancer Res Treat. 2004;36(2):157-159. Published online April 30, 2004; DOI: https://doi.org/10.4143/crt.2004.36.2.157

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Isolated diaphragmatic metastasis arising from colorectal cancer has been reported only one case in the literature presently. Here, we presented a new case and discussed the possible pathogenesis and the treatment options. A 42-year-old male patient had received anterior resection for sigmoid colon cancer. Although the increased serum CEA level was detected 20 months after the surgery, metastatic lesion could not be detected by repeated colonoscopy, CT scan, bone scan or PET scan for 35 months. We could detect a suspicious metastatic lesion on the liver by CT scan at 56 month after the surgery. During a second-look operation, we found a solitary metastasis on the diaphragm and removed it along with the 1 cm tumor-free resection margin. Although the prognosis associated with skeletal metastasis is poor, the complete resection of isolated diaphragmatic metastasis and subsequent appropriate adjuvant chemotherapy may achieve a cure the disease provided that other metastatic lesions are absent.

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Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2013; 74(10): 2829. CrossRef
A case of solitary diaphragmatic metastasis originating from a sigmoid colon cancer resected during thoracoscopic surgery
Kazuo MOTOYAMA, Kenta KOBAYASHI, Naoki ENOMOTO, Yoshihiro UEDA, Ryo OHNO
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Original Articles

Genomic Identification of N-Trminal Domail Exons of Carcinoembryonic Antigen in Human Colon Carcinoma: Jin Cheon Kim, Sun Ae Noh, Kun Choon Park, In Kwon Jung; J Korean Cancer Assoc. 1998;30(4):675-682.

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Establishment and Biological Carcterization of Human Colorectal Carcinoma Cell Lines Expressiong Carcinoembryonic Antigen: Jin Cheon Kim, In Chul Lee, Seon Ae Roh, Yoo Kyung Lee, Kyung Sin Kim, Kun Choon Park; J Korean Cancer Assoc. 1996;28(1):63-72.

Abstract PDF: For serum carcinoembryonic antigen (CEA) is not always elevated in recurrence or metastasis of colorectal carcinoma (CRC), activation of colorectal carcinoma cells by CEA may be selective. We have established and characterized two CEA-expressing colorectal carcinoma cell lines which were analysed in relation to the clinical course. Two cell lines originated from rectal carcinoma were cultured in DME enhanced media and subcultured by 40 and 55 times respectively. AMC 4 grew in an anchrage-independent with delayed cell doubling time (93 hrs), while AMC 5 did in an anchorage-dependent with normal doubling time (43 hrs). Tumorigenesis revealed infiltrative moderate-differentiated adenocarcinoma in AMC 4 and expansile well-differentiated adenocarcinoma in AMC 5. Karyotyping by Trypsin-Giemsa banding showed 47, XY, 21(+ ), del (2q, 5q) and 46, XY, 5(+ ), 20(+ ), 12(- ) respectively. Both cell lines were aneuploid. AMC 5 expressed large amount of 55 kD NCA as well as 180 KD CEA, but AMC 4 did traces of them by indirect immunofluorescence and immunoblot. AMC 5 cells bound optimally to solid-phase type IV collegen, laminin, and CEA by 18.7¡¾ 0.4, 21.4 ¡¾ 0.6 and 17.7¡¾0.4, while AMC 4 cells bound less. The patient of AMC 4 showed liver metastasis on 6 months after curative surgery and AMC 5 did no evidence of recurrence. In conclusion, biological characteristics of two CEA-expressing CRC cell lines seemed to be consistent with their clinical course.

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