Summary.-Eighty-two per cent of tumour sections from 105 patients with lung cancer showed positive immunocytochemical localization of an anti-carcinoembryonic antigen (CEA) immunoglobulin free of antibody to normal cross-reacting antigen (NCA). The highest incidence was found in adenocarcinomas, and no association between staining and disease stage was found. There was a relationship between positive-staining tumours and preoperative and postoperative serum CEA levels of >,20 ng/ml, but the high incidence of CEA+, <20 ng/ml serum patients indicated that immunocytochemical localization was of little value in selecting patients for sequential serum monitoring. Staining for CEA was not prognostic but a preoperative serum CEA level 3z20 ng/ml was associated with a poor prognosis in patients undergoing radical surgery for lung cancer (P=0-043). This prognostic effect of CEA was seen mainly in patients whose tumours showed the greatest immunocytochemical localization (P=0 017) and in Stage III patients (P=0.04).
SUMMARY The expression of carcinoembryonic antigen (CEA) was evaluated by immunoperoxidase staining with two anti-CEA monoclonal antibodies in normal, chronically inflamed, and malignant pancreatic tissue. Positive staining was not observed in normal specimens. In pancreatic cancer the expression of CEA was related to the degree of differentiation of the tumour. Positive staining was also observed in chronic pancreatitis.
Concensus Statement, 1981), these studies have shown that blood levels possess a limited role in tumour diagnosis and are a relatively late indicator of disease in tumour monitoring (Finlay & McArdle, 1983). However, more recently attention has been focused on the exploitation of the tumourassociated properties of CEA for radiolocalisation (Goldenberg et al., 1978a) and targeting of tumoricidal agents (Rowland et al., 1982). Whether or not this potential will be realised in terms of clinical use will depend on several factors. We feel that the most important of these include the incidence of tumours which express CEA and the degree and significance of variation in antigen expression between patients' tumour cells. Antigenic heterogeneity has been observed (Jones, 1981). Samples were available from the primary tumours of all 119 patients and from 81 of these who also had at least one histologically confirmed lymph node metastasis. Two hundred and fifty-seven lymph nodes were assessed; 210 contained metastases.
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