2010 Volume 20 Issue 1 Pages 31-34
An elevated CEA, confirmed by retesting, needs further evaluation for metastatic disease, but does not justify the institution of adjuvant therapy or systemic therapy for presumed metastatic disease. It is because of CEA has only moderate 70% sensitivity and specificity. Decreasing CD4, CD8 and ratio of CD4/CD8 increase the specificity of this CEA function. This study figured a fishbone and then transformed to firecrackers of APC, K-ras, p53, DCC mutation, microsatellite instability which has commonly occured during the evolution of adenomatous polyp, severe dysplasia to carcinoma. The position of the dancing of CD4 and CD8-PE is put on this firecrackers corridor. Using the dancing of CD4 and CD8-PE is along with T-reg (T4reg and T8reg) in the time sequence firecrackers with upregulated-downregulated gen sequences. Up and down of CD4 and CD8 react in between each gene mutation stage., increase the sensitivity and specificity of CEA (CD66e) for CRC prognosis. Quasi experimental got ten patients pre- and post-operative CRC. Analyzing were done with Fisher exact test for categorical determination. Decreasing CD8+ and CD4/CD8 has increased the sensitivity and specificity of CEA to 100%.
