Carcinoembryonic antigen (CEA) is elevated in a patient recovering from a resected sigmoid colon adenocarcinoma. A rising post-operative CEA level is best interpreted as:
- A Definitive evidence of peritoneal metastasis specifically
- B A marker that, when rising serially after resection, is a sensitive indicator of recurrence warranting further imaging ✓
- C A specific marker for hepatocellular carcinoma that confirms liver metastasis
- D A non-specific finding of little clinical utility in post-resection surveillance
Correct answer: B. A marker that, when rising serially after resection, is a sensitive indicator of recurrence warranting further imaging
Explanation
CEA is a glycoprotein expressed on fetal gut epithelium and re-expressed by many adenocarcinomas. It lacks the sensitivity/specificity to diagnose malignancy or determine metastatic site, but serial post-resection monitoring is clinically validated: a rising CEA level with a doubling trend is a sensitive indicator of colorectal cancer recurrence and prompts CT imaging to localize disease (liver, lung, local recurrence). It is not specific for hepatocellular carcinoma — that marker is AFP — and does not localize to peritoneum specifically.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.