CEA Levels in Gastric Juice in Precancerous Conditions and Cancer

Abstract

First described in 1965 as a specific antigen for cancer of the colon, CEA is now considered to be an antigen associated with many types of malignant neoplasia, although the CEA-Test's role in clinical routine has yet to be clearly defined. In the present study CEA levels in gastric juice were measured in subjects with gastric carcinoma (n = 25) and with benign gastric lesions (n = 171). CEA was significantly (p < 0.05) higher in patients with gastric carcinoma (GC) than in subjects with benign gastric lesions, other than chronic atrophic gastritis (CAG) associated with intestinal metaplasia (IM). In this latter condition CEA levels were similar to those in patients with GC. These results suggest that the assay of CEA in gastric juice could be included in the diagnostic program for gastric cancer and its precursors with the aim of assessing its utility as risk indicator in the management of precancerous conditions and lesion.

Measuring Intragastric Tumor Markers in Gastric Cancer Patients: a Systematic Literature Review on Significance and Reliability

“…This sort of research has certainly added novel and notable information to the knowledge of the pathobiology of GC, such as the possibility of better identifying and monitoring patients with precancerous lesions furnished by analysis of GJ CEA (19)(20)(21)(22)(23). However, none of the aforementioned works managed to materialize the ideal tumor antigen including CEA, Ca 19.9, Ca 72.4 or Ca 50 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). The intragastric determination on tumoral antigens, in fact, appears to be undermined by the low sensitivity of the test itself (18,25,26,29,30).…”

“…Through the years, clinical laboratories improved the methods of determining intragastric tumor antigens changing from qualitative to quantitative detection method, from manual add sample to automatic detection, from ELISA to chemiluminescence. Regarding the determination of GJ/GL tumor markers of GC patients, only 19 dedicated works exist in the world literature so far and this field of oncologic research covers a very limited span of time (approximately 40 years) (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). The main features pertaining to the heritage of this scientific niche are summarized in Table I.…”

“…Carcinoembryonic antigen (CEA) represents the endogastric tumor marker which was first investigated by the medical community and the one better analyzed to date as witnessed by the large amount of dedicated works (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(26)(27)(28)(29)(30). Historically, CEA was immunohistochemically detected both in normal and neoplastic gastric mucosa in 1972, but it was not until 1975 that Go and colleagues pioneered the determination of CEA levels in gastrointestinal secretions (12).…”

“…The same year, on the contrary, Satake and colleagues suggested the analysis of GJ CEA as a useful adjunct to the diagnosis of early malignant changes in the gastric mucosa: in fact, there was a significant difference between benign gastric disease and EGC (p<0.01) as well as between benign and late GC (p<0.001) (19). Of interest, all the following pertinent literature (namely Nitti et al in 1983, Borch et al in 1987, Amadori et al in 1987and, again, Tatsuta et al in 1988) was in accordance with Satake's perspective: in fact, in all these works, elevated GJ CEA levels significantly correlated with those types of gastric intestinal metaplasia showing the potential for neoplastic transformation and, later on, this appeared to be the actual significance of the gastric CEA test (20)(21)(22)(23). In 1986 Wang and associates proposed the combined determination of CEA and immunoglobin to improve the diagnostic accuracy of GC and the identification of precancerous lesions; although this was an interesting suggestion, no continuation succeeded in line with their model of analysis (24).…”

“…The capsular method. Since the first study on gastric tumor marker, the procedure of getting samples of GJ from GC patients has always been through nasogastric or orogastric catheter (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). With this regard, in 2003, Muretto and colleagues first described the successful employment of an endogastric capsule for measuring CEA and Ca 19.9 in GJ of 23 Italian GC patients (28).…”