Is ultrasound superior to carcinoembryonic antigen (CEA) measurement in recurrent tumor screening of patients with colorectal carcinoma?

Assuming that in the postoperative recurrent tumor screening CEA levels are as important as imaging techniques in elucidating the spread or the recurrence of a tumor, we examined 61 patients with colonic carcinoma. Those patients were operated curatively and were regularly controlled by clinical examination, laboratory, sonographic, endoscopic or radiological methods. In 3 patients there was a local recurrent, in 3 other patients there was a local recurrent and metastases. 8 patients showed sonographic livermetastases only, proved by computed tomography. In 6 patients CEA-levels rose. In 2 patients with sonographically confirmed metastases of the liver, there were neither clinical nor laboratory hints for metastases and the CEA-levels were normal. No one had elevated CEA-levels before detecting metastases. Our results indicate that ultrasound of the liver can detect metastases of colonic tumors earlier than clinical or laboratory sings do. Because of its greater diagnostic security, ultrasound is superior to CEA-measurement in recurrent tumor screening.