癌症防治-CEA檢驗正常竟復發腸癌 醫:術後追蹤工具需升級 – 中時電子報
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癌症防治-CEA檢驗正常竟復發腸癌 醫:術後追蹤工具需升級
2015年06月01日 05:55
中國時報
李盛雯/台北報導
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亞東紀念醫院大腸直腸外科醫師林耿立
大腸癌患者張爺爺,因為抗拒大腸鏡檢查,追蹤期間只進行傳統CEA檢驗,兩年來數值都在正常範圍。今年張爺爺終於決定進行大腸鏡檢查,沒想到竟發現癌症復發,張爺爺沮喪的說,CEA指數不是都正常嗎?為什麼還會復發呢?亞東紀念醫院大腸直腸外科醫師林耿立表示,其實像張爺爺這樣的案例並不少見,臨床經驗顯示,CEA指數容易受到個人體質及健康狀況影響,有將近1/3的大腸直腸癌患者CEA指數根本不會升高,單憑術後的檢測結果,醫療團隊難以判別癌症是否復發。
癌症防治-CEA檢驗正常竟復發腸癌 醫:術後追蹤工具需升級 - 中時電子報
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癌症防治-CEA檢驗正常竟復發腸癌 醫:術後追蹤工具需升級
2015年06月01日 05:55
中國時報
李盛雯/台北報導
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亞東紀念醫院大腸直腸外科醫師林耿立
大腸癌患者張爺爺,因為抗拒大腸鏡檢查,追蹤期間只進行傳統CEA檢驗,兩年來數值都在正常範圍。今年張爺爺終於決定進行大腸鏡檢查,沒想到竟發現癌症復發,張爺爺沮喪的說,CEA指數不是都正常嗎?為什麼還會復發呢?亞東紀念醫院大腸直腸外科醫師林耿立表示,其實像張爺爺這樣的案例並不少見,臨床經驗顯示,CEA指數容易受到個人體質及健康狀況影響,有將近1/3的大腸直腸癌患者CEA指數根本不會升高,單憑術後的檢測結果,醫療團隊難以判別癌症是否復發。
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國內目前大腸直腸癌術後追蹤工具中,傳統CEA檢測相當於癌症復發的情報站,醫師會依據檢驗的結果,規劃下一步的檢測或治療方向。但考量傳統CEA精準度不足的疑慮,另一個同樣簡易、非侵入性且精準度較高的術後追蹤方式DR-70,則是醫師及患者術後追蹤的新選擇。因為與CEA機轉不同,DR-70的高靈敏度可以輔助傳統CEA腫瘤標記,使癌細胞在生長初期就被精準偵測,讓醫療團隊可以更全面掌控大腸直腸癌的術後追蹤情況,加強癌症復發的風險管理。DR-70只需抽取5cc血液就可進行檢測,大幅增加了術後追蹤的便利性。林耿立強調,無論使用CEA或DR-70,最好都要做到「術前術後對照」,因為個人體質及身體狀況會有些許差異,每位患者的檢測結果也都不盡相同,醫師會將手術前後的檢測數據建立為個人的基準值,當作追蹤的評估標準,對照術後的檢測結果,就可以更精確判斷患者是否癌症復發。林耿立建議,考量DR-70的高靈敏度,患者在經濟許可的狀況下,可以在手術前進行DR-70檢測,術後若醫師評估CEA檢測結果無法提供準確癌復發情報,需要檢驗DR-70時,就有足夠的資料提供醫師做判斷,更精確評估病情發展,為患者術後追蹤做嚴格把關。,