Increased Carcinoembryonic Antigen Concentrations in Sera and Bronchoalveolar Lavage Fluids of Patients with Pulmonary Alveolar Proteinosis

Abstract

Pulmonary alveolar proteinosis (PAP) is a rare disease in which alveoli are filled with lipoproteinaceous materials. We measured carcinoembryonic antigen (CEA) concentrations in bronchoalveolar lavage (BAL) fluids and sera from patients with PAP and from healthy volunteers (HV). Significantly increased CEA values were found in BAL fluids and sera from patients with PAP compared with those from HV. BAL fluid CEA values significantly correlated to serum CEA values in patients with PAP. Serum CEA values significantly correlated to serum lactate dehydrogenase activity and alveolar-arterial PO₂ difference values in patients with PAP. Successive measurements of serum CEA showed that serum CEA values reflect the disease activity of PAP. The determination of serum CEA is useful for evaluating disease severity of PAP.

Relationship of anti-GM-CSF antibody concentration, surfactant protein A and B levels, and serum LDH to pulmonary parameters and response to GM-CSF therapy in patients with idiopathic alveolar proteinosis

“…Protein products of pulmonary epithelial cells including carcinoembryonic antigen (CEA) 40 and the mucin KL-6 41 42 have also been found to be increased in the serum of patients with pulmonary AP and suggested as potential markers of disease severity. The levels of CEA were significantly correlated with [A -a]DO 2 and serum LDH, and declined following successful therapeutic lavage in the three cases examined serially.…”

Characteristics of a Large Cohort of Patients with Autoimmune Pulmonary Alveolar Proteinosis in Japan

“…Serum KL-6, SP-A, and SP-D were measured by ELISA using commercial kits (ED046; Eizai Co. Ltd., Tokyo, Japan; SP-A Test Kokusai-F, International Reagents Co. Kobe, Japan; SP-D ELISA; Yamasa Co., Tokyo, Japan; respectively) as described previously (29)(30)(31)(32). Serum carcinoembryonic antigen (CEA) level was measured by radioimmunoassay using monoclonal antibodies (Dainabott, Tokyo, Japan) as described previously (33). Normal serum ranges were KL-6 (,500 U/ml), SP-A (,43.8 ng/ml), SP-D (,110 ng/ ml), and CEA (,2.5 ng/ml) (30)(31)(32)(33)(34).…”

“…Serum carcinoembryonic antigen (CEA) level was measured by radioimmunoassay using monoclonal antibodies (Dainabott, Tokyo, Japan) as described previously (33). Normal serum ranges were KL-6 (,500 U/ml), SP-A (,43.8 ng/ml), SP-D (,110 ng/ ml), and CEA (,2.5 ng/ml) (30)(31)(32)(33)(34). The normal range for lactate dehydrogenase (LDH) in the clinical laboratory used was ,230 IU/L.…”

Pulmonary Alveolar Proteinosis

“…Similarly, tumor markers, such as squamous-cell carcinoma antigen, carcinoembryonic antigen, carbohydrate antigen 19-9, and cytokeratin 19 fragments, have been used in assessing pulmonary alveolar proteinosis. 143,144 However, the clinical value of measuring these tumor markers in serum or BALF for diagnosis or severity assessment remains inconclusive. 124 …”