Carcinoembryonic Antigen in Colonic Lavage

Winawer, Sidney J.; Fleisher, Martin; Green, Saul; Bhargava, D. K.; Leidner, Sheldon D.; Boyle, Camille; Sherlock, Paul; Schwartz, Morton K.

doi:10.1016/s0016-5085(19)31772-x

Gastroenterology

1977

DOI: 10.1016/s0016-5085(19)31772-x

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Carcinoembryonic Antigen in Colonic Lavage

Sidney J. Winawer

Martin Fleisher

Saul Green

et al.

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1978

1993

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Cited by 32 publications

(2 citation statements)

References 16 publications

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“…by using colonic effluent samples including feces (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). by using colonic effluent samples including feces (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

mentioning

confidence: 99%

“…The need to better understand the source of gut antigens shed in the colonic effluent is underscored by recent articles showing substantial protease activity in colonic effluent (15,16) and by previous authors who have addressed problems of standardization (3). Much of the previous work attempting to use colonic antigens as a method of diagnosing colorectal cancer has been performed using carcinoembryonic antigen CEA), which undergoes little breakdown in stools and can be readily quantified (1)(2)(3)(4)(5)17).…”

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confidence: 99%

See 1 more Smart Citation

Mucosal Origin and Shedding of an Early Colonic Tumor Marker Defined by Adnab-9 Monoclonal Antibody

Tobi

Elitsur

Moyer

et al. 1993

Scandinavian Journal of Gastroenterology

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Recent attention has been drawn to the diagnostic potential of tests based on shed colonic tumor markers. Adnab-9 monoclonal antibody raised against neoplastic, potentially premalignant colonic adenomas recognizes a marker in colonic effluent or tissue which correlates with the presence of tumors or risk of colorectal cancer. The origin of this antigen and optimal collection of colonic effluent were investigated by enzyme-linked immunosorbent assay and Western blotting. Mean Adnab-9 binding in effluent samples from colorectal cancer patients even after resection is high as compared with that in normal subjects (P < 0.05). Effluent samples are best collected in the morning hours. Antigen proteolysis may be significant depending on the site and timing of effluent collection, but breakdown products are reactive. Tissue and effluent Adnab-9 binding at any one anatomic site of collection appear to correlate (r = 0.88, P = 0.01). The Adnab-9 antigen is constitutively expressed at low levels throughout the distal bowel and localized to the deepest regions of the mucosal crypts. Other than meconium, no significant levels of binding are found in other body fluids. This antigen is specific for the gastrointestinal tract, its binding in conveniently collected effluent samples correlates with tissue content, and the antigen is constitutively expressed in the crypts of the distal small bowel and colonic mucosa.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Mucosal Origin and Shedding of an Early Colonic Tumor Marker Defined by Adnab-9 Monoclonal Antibody

Tobi

Elitsur

Moyer

et al. 1993

Scandinavian Journal of Gastroenterology

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Carcinoembryonic antigen (CEA) levels in benign gastrointestinal disease states

Loewenstein¹,

Zamcheck²

1978

Cancer

124

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Elevated circulating CEA levels occur in patients with benign gastrointestinal and hepatic disorders. These are usually less than 10 ng/ml. Of clinical importance is the influence of liver disease on the interpretation of CEA. At least 50% of patients with severe benign hepatic disease have elevated CEA levels, most often active alcoholic cirrhosis, and also chronic active and viral hepatitis, and cryptogenic and biliary cirrhosis. Patients with benign extrahepatic biliary obstruction may have increased plasma CEA, the highest in patients with co-existent cholangitis and especially liver abscess. The liver appears to be essential for the metabolism and/or excretion of CEA. Hence, liver work-up is needed to assess any patient with an elevated CEA. A damaged liver may further augment elevated CEA levels due to cancer. The increased circulating CEA observed in some patients with active ulcerative colitis tends to correlate with severity and extent of disease and usually returns to normal with remission. CEA levels also may be mildly elevated in patients with pancreatitis and in adults with colonic polyps. Smoking may contribute to the increased CEA levels seen in patients with alcoholic liver disease and pancreatitis. Therefore, in interpreting mildy elevated circulating CEA levels in patients with GI tract diseases, one must consider benign as well as malignant etiologies.

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Colonoscopic biopsy and cytology in the diagnosis of colon cancer

Winawer

Leinder

Hajdu

et al. 1978

Cancer

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Colonoscopy has revolutionalized the approach to the diagnosis and management of patients with colorectal neoplasia. When malignant-appearing lesions are visualized by colonoscopy, a variety of diagnostic techniques are currently available for the assessment of the nature of the lesion including biopsy, brush cytology, and lavage cytology. Comparison of results for biopsy alone with biopsy plus either or both cytologic techniques showed a positive yield of 60% for biopsy alone; 76% for biopsy and lavage; 89% for biopsy, brush, and lavage. When the cancers were divided ihtb infiltrative and exophytic lesions the positive yield for biopsy alone was 33% for infiltrative cancer, and 71% for exophytic cancer; for biopsy and lavage cytology, 44% for infiltrative cancer, and 94% for exophytic cancer; for biopsy and brush Cytology, 78% for infiltrative, and 94% for exophytic cancer; and for biopsy, brush, and lavage cytology, 83% for infiltrative cancer, and 92% for exophytic cancer. The use of brush cytology improved the yield of tissue diagnosis considerably when added to the biopsy technique. Lavage cytology did not seem to increase significantly the diagnostic yield. The diagnostic yield of the various techniques was related not only to the specific combination of techniques used, but also to the gross tumor pattern.

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Carcinoembryonic Antigen in Colonic Lavage

Cited by 32 publications

References 16 publications

Mucosal Origin and Shedding of an Early Colonic Tumor Marker Defined by Adnab-9 Monoclonal Antibody

Mucosal Origin and Shedding of an Early Colonic Tumor Marker Defined by Adnab-9 Monoclonal Antibody

Carcinoembryonic antigen (CEA) levels in benign gastrointestinal disease states

Colonoscopic biopsy and cytology in the diagnosis of colon cancer

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