Carcinoembryonic antigen (CEA) is more abundant in feces than in serum; however, evidence for the role of fecal CEA (FCEA) in the detection of colorectal cancer (CRC) is limited. We conducted a systematic review of studies that evaluated FCEA for the noninvasive detection and diagnosis of CRC. PubMed and Web of Science were searched for relevant studies published until 18 January 2023. Information on publication year, study design, country, study population characteristics, FCEA and serum CEA (SCEA) concentrations, and diagnostic performance was summarized. Two authors independently extracted data and assessed the risk of bias and applicability of each included study. Seven studies published between 1979 and 2021, all conducted in clinical settings and together involving 399 CRC patients and 889 controls, were identified. Significant differences in FCEA concentrations were observed between CRC and control groups in all studies. Methods for detecting FCEA varied, with the electronic chemiluminescence immunoassay (ECLIA) being used in the most recent studies. Reported sensitivities, specificities, and area under the curves of FCEA ranged from 50.0% to 85.7%, 73.0% to 100.0%, and 0.704 to 0.831, respectively. In direct comparisons, the diagnostic performance of FCEA was better than that of SCEA. The potential role of FCEA as a novel, noninvasive, easily measurable biomarker for the diagnosis of CRC requires further evaluation in screening settings.
癌胚抗原（CEA）在粪便中的含量高于血清，但关于粪便CEA（FCEA）在结直肠癌（CRC）检测中作用的证据有限。本研究系统综述了评估FCEA用于无创检测和诊断CRC的相关研究。通过检索截至2023年1月18日发表于PubMed和Web of Science的相关文献，汇总了发表年份、研究设计、国家、研究人群特征、FCEA与血清CEA（SCEA）浓度及诊断效能等信息。由两位研究者独立提取数据，并对纳入研究的偏倚风险及适用性进行评估。最终纳入1979年至2021年间发表的7项研究，均在临床环境中开展，共涉及399例CRC患者和889例对照者。所有研究均显示CRC组与对照组的FCEA浓度存在显著差异。FCEA检测方法多样，最新研究多采用电化学发光免疫分析法（ECLIA）。文献报道的FCEA诊断敏感性、特异性及曲线下面积范围分别为50.0%-85.7%、73.0%-100.0%及0.704-0.831。在直接比较中，FCEA的诊断效能优于SCEA。FCEA作为一种新型、无创、易测的生物标志物在CRC诊断中的潜在作用，需在筛查场景中进一步验证。
肿瘤(癌症)患者之家