Relation between Carcinoembryonic Antigen Levels in Colon Cancer Tissue and Serum Carcinoembryonic Antigen Levels at Initial Surgery and Recurrence

Abstract

Objectives: Carcinoembryonic antigen (CEA) is widely used for postoperative surveillance of colon cancer. Even if serum CEA is negative at initial surgery, it may turn positive at recurrence. We investigated the relation between serum CEA levels and the immunohistochemical staining status of CEA in the primary and resected metastatic tissues. Methods: Out of 224 patients with recurrent colon cancer between 1998 and 2012, we studied 46 patients in whom serum CEA levels were measured and immunohistochemical staining for CEA was possible in the primary and metastatic tissues. Results: The positive rate of serum CEA did not differ between initial surgery and recurrence, regardless of whether the cutoff value was set at 5 or 10 ng/ml (p = 0.829, p = 0.671). There was no relation between the CEA staining status and serum CEA level at initial surgery. However, the CEA staining status of metastatic tissue was significantly related to the serum CEA level at recurrence (p = 0.0046 and p = 0.0026). Conclusions: The immunohistochemical staining status of CEA in metastatic tissue is closely related to the serum CEA level. This finding suggests that serum CEA levels are influenced not only by the CEA production capacity of cancer cells but also by the ability of the surrounding tissue to release CEA into the blood.

Monitoring of Serum Carcinoembryonic Antigen Levels after Curative Resection of Colon Cancer: Cutoff Values Determined according to Preoperative Levels Enhance the Diagnostic Accuracy for Recurrence

“…We previously reported that although immunohistologically evaluated CEA staining in primary colon cancer tissue is not significantly related to the serum CEA level, CEA staining of metastatic tissue is intimately related to the serum CEA level [9] . This is attributed to the facts that serum CEA levels are related to the secretional capacity of CEA into blood and that the tissue environment around cancer cells differs between primary lesions and metastatic lesions.…”

“…The rateclinical stage of colorectal cancer. Patients with metastasis often have particularly high serum CEA levels [3][4][5][6][7][8][9] . Serum CEA has a half-life of 3-5 days, and serum CEA levels have been reported to decrease to the normal range from 2 weeks to 1 month after curative resection [5,[10][11][12][13] .…”

A Review of the Role of Carcinoembryonic Antigen in Clinical Practice

“…At the cellular level, a correlation between the immunohistochemical status of CEA staining and the serum CEA level was found in colorectal metastases, but not in the primary tumors [30], suggesting that serum CEA levels are influenced both by the production of CEA in tumor cells and by its release into the bloodstream. Positive staining for CEA in metastatic tissue also carried a worse survival.…”

Hubungan Nilai Carcinoembryonic Antigen dengan Derajat Diferensiasi pada Karsinoma Kolorektal di RSUP Prof. Dr. R. D. Kandou Manado

“…Beberapa penelitian telah menunjukkan bahwa KKR dengan diferensiasi baik memroduksi lebih banyak CEA per gram total protein dibanding dengan spesimen yang berdiferensiasi buruk. Saito 7 melaporkan bahwa adenokarsinoma berdiferensiasi baik memiliki kadar CEA tertinggi serta pewarnaan yang kuat, sedangkan adenokarsinoma berdiferensiasi buruk memiliki kadar CEA serum rendah serta pewarnaan yang lemah dengan cut-off point 5 ng/ml. Pada penelitian Duffy 8 didapatkan hasil rerata kadar CEA pada tumor berdiferensiasi baik, sedang, dan buruk secara respektif ialah 18,0; 5,5; dan 2,2 ng/ml.…”

“…Kurangnya atau buruknya diferensiasi yang mungkin dapat menjelaskan mengapa pada beberapa pasien dengan KKR stadium lanjut tidak mengalami peningkatan kadar CEA. 7 Hal ini juga ditunjang oleh Polat et al 9 yang menyatakan bahwa kadar CEA serum mengalami tren peningkatan pada pasien dengan tumor berdiferensiasi baik dibandingkan pada tumor berdiferensiasi buruk. Hasil penelitian oleh Li 10 menyatakan bahwa kadar CEA serum cenderung lebih meningkat pada pasien KKR berdiferensiasi baik dibanding dengan yang berdiferensiasi buruk yang menunjang hasil penelitian ini, dan juga diperkuat oleh Bhatnagar 11 yang melaporkan bahwa kadar CEA jaringan ialah yang tertinggi pada adenokarsinoma berdiferensiasi baik (5,2-37 µg/gr protein) dan sangat rendah pada adenokarsinoma berdiferensiasi sedang dan buruk, dan pada individu normal.…”