Carcinoembryonic Antigen in Management of Colorectal Carcinoma

Serum CEA testing in the post-operative surveillance of colorectal carcinoma

“…The rate of rise was shown that a CEA rise was the first indication of recurrence in the majority of patients developing secondary disease (Mach et al, 1974;Booth et al, 1974;Herrera et al, 1976). In the present study there was a proven or suggestive recurrence rate of 27.3% after a mean follow-up of 39.7 months.…”

“…Much of the initial enthusiasm for the test evaporated as it became apparent that serum CEA testing lacked specificity and sensitivity (Sugarbaker et al, 1976;Sorokin et al, 1974) and it has since been shown to be of minimal value in the primary diagnosis of gastrointestinal disease (Hine et al, 1978). However, in the post-operative surveillance of patients who have had radical resections of colorectal carcinomas, several studies have shown that a rise in the serum CEA precedes clinical recurrence in the majority of cases (Sorokin et al, 1974;Mach et al, 1974;Booth et al, 1974;Herrera et al, 1976;Wood et al, 1978). In some instances the lead-time has been up to 29 months (Sorokin et al, 1974).…”

Clinical applications of serum carcinoembryonic antigen and alpha-fetoprotein levels in children with solid tumours.

“…In other patients blood for CEA and AFP levels was taken during venepuncture for other investigations, or for the administration of cytotoxic drugs. The patients' ages ranged from 5 days to 15 years, 11 being aged less than one year, and their diagnoses are shown in Tables 1 and 2. CEA levels were measured by the double-antibody technique, the 95% confidence limits of normal healthy adults being 0-15 ng/ml, standard error 1 9 (Booth et al, 1974). In some patients a comparison was made, using the same sera, with CEA levels measured by the Z-gel method (Lo Gerfo et al, 1971), the normal upper limit in healthy adults being 2 5 ng/ml, the reproducibility of the CEA Roche assay being 0 5 ng/ml at this level.…”

“…However, although about 70% of patients with gastrointestinal malignancy have raised levels, raised CEA has since been found in patients with other adult cancers (Booth et al, 1973;Neville and Laurence, 1974) and certain nonmalignant disorders. Nevertheless, serial studies have shown that in adult patients with CEA-releasing colorectal carcinomas serum levels fall if treatment is successful and rise again when metastases occur (Booth et al, 1974). Studies of serum CEA in children with neuroblastoma (Reynoso et al, 1972;Wang et al, 1974;Frens et al, 1976) showed that serum CEA levels were usually raised when active tumour was present and fell when treatment was successful.…”

Review of general surgery 1974

“…assays in detection of recurrent and metastatic colo-rectal cancer. Booth et al (1974) have used C.E.A. estimation in the preoperative assessment of colo-rectal carcinoma and have shown that a serum concentration of 100 ng/ml or more is a useful guide to the presence of metastatic disease and ultimately to poor prognosis, and to be more reliable as an index of tumour spread than either clinical examination or serum alkaline phosphatase estimation.…”