CEACAM5 and metastatic neoplasm: While postoperative serum carcinoembryonic antigen (CEA) level is routinely used as a marker for possible metastatic disease, the perioperative CEA ratio (post-op/pre-op CEA) may be an important emerging prognostic factor for CRC patients [4,5] and may be especially important in patients with high preoperative CEA levels [6].