The effect of serum protein concentrations on the specificity of the radioimmunoassay of carcinoembryonic antigen in malignant neoplasia and non-neoplastic disease

Crawley, Jim; Northam, B. E.; King, Janet; Leonard, J. C.; Booth, Sarah; Dykes, P. W.

doi:10.1136/jcp.27.2.130

J Clin Pathol

1974

DOI: 10.1136/jcp.27.2.130

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The effect of serum protein concentrations on the specificity of the radioimmunoassay of carcinoembryonic antigen in malignant neoplasia and non-neoplastic disease

Jim Crawley¹,

B. E. Northam²,

Janet King³

et al.

Abstract: SYNOPSIS Carcinoembryonic antigen (CEA) has been measured in parallel with seven serum proteins and seromucoids in the sera of patients with malignant neoplasia and non-neoplastic disease. In the total group significant correlations were found between CEA and seromucoids and between CEA and several serum proteins. However, with two exceptions, when the individual disease groups were examined no correlation was seen. It is concluded that abnormal concentrations of the specific proteins measured do not consisten… Show more

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1975

1981

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Cited by 9 publications

References 12 publications

(6 reference statements)

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Correlations among serum protein-bound carbohydrates, serum glycoproteins, lymphocyte reactivity, and tumor burden in cancer patients

Bradley¹,

Blasco²,

Weiss³

et al. 1977

Cancer

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Levels of glycoprotein-associated carbohydrates (neutral hexoses, hexosamine, sialic acid and fucose) were determined in the serum of patients with either local, regional or metastatic cancer, patients clinically cured of cancer, and controls (smokers and nonsmokers). Total protein-bound carbohydrates were compared with levels of 17 normal serum glycoproteins, carcinoembryonic antigen (CEA), and with lymphocyte reactivity to phytohemagglutin (PHA). Tumor burden was directly related to protein-bound carbohydrate levels in patient groups. Levels of bound carbohydrates reflect the sum of all the changes in serum glycoproteins, but primarily changes in the acute-phase proteins (alpha 1-acid glycoprotein, alpha 1-antitrypsin, haptoglobin, ceruloplasmin) found in the alpha-globulin fraction of serum. Increases in protein-bound carbohydrates in tumor-bearers were not related to increases in CEA. Increased levels of the acute-phase proteins occurred in individuals with depressed in vitro lymphocyte reactivity to PHA. A significant positive correlation was found between lymphocyte reactivity and level of alpha 2HS-glycoprotein. The results suggest that serum protein-bound carbohydrates or glycoproteins may be of adjunctive value is assessing tumor burden and immune reactivity in cancer patients.

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Correlations among serum protein-bound carbohydrates, serum glycoproteins, lymphocyte reactivity, and tumor burden in cancer patients

Bradley¹,

Blasco²,

Weiss³

et al. 1977

Cancer

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The disparity of indirect and direct zirconylgel assays for carcinoembryonic antigen

Kupchik¹,

Loewenstein²,

Feil³

et al. 1978

Cancer

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Experience with the zirconyl phosphate gel (Z-gel) radioimmunoassays for plasma CEA levels below 20 ng/ml (the indirect method) and for levels greater than 20 ng/ml (the direct method) has shown that a disparity of values exists, caused by shifting from one assay to the other. This disparity is at least partially due to PCA-labile proteins reacting in the direct assay. It may be constant for individual patients but varies among patients. The magnitude of this disparity is independent of the CEA level (above 15 ng/ml). useful range of this assay when performed as recommended by the manufacturer is approximately 1 to 20 ng/ml. Because many cancer patients have much higher levels, a modification of the Z-gel assay was developed by Roche for quantitation above 20 ng/ml. Since this method does not utilize PCA extraction, it is called a "direct" method. Instructions with the CEA-Roche kit state that the direct assay must be utilized to obtain reliable values when the indirect assay reads above 20 ng/mLZ0 The need to use the indirect assay before using the direct assay has been emphaFurther studies by this laboratory, Rule et al., Madsen et al., and Taylor et al. have shown that a disparity of values occurs when shifting from one Z-gel assay to the other as r e c~m m e n d e d . '~~'~*~~~~~ These studies emphasized the clinical implications of this disparity for physicians attempting to interpret assay results. The purpose of this study was to determine if the magnitude of the disparity (when the assays are performed as recommended) was related to the CEA level and whether it varied among patients. MATERIALS A N D METHODS Patient SamplesBlood samples were routinely collected in standard vacutainer tubes (Becton, Dickinson and Co.) containing ethylene diaminetetraacetic acid (EDTA). Samples were centrifuged at 2000 x g for 15 minutes and the plasma withdrawn. Plasma samples were kept frozen at -40 C until tested. Since ascitic and pleural fluids have a wider range of protein concentration than does plasma, these were also

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Cancer serum index: A useful nonspecific test as a parameter in multimodality screening and assessment of patients with cancer of the prostate

et al. 1981

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A satisfactory, simple test for screening and monitoring of patients with prostatic cancer is still being sought. We suggest the use of a nonspecific test in combination with other tests. The ratio of two serum proteins (alpha 1 acid glycoprotein [AGP] and prealbumin [PAB]), may be useful markers for a cancer serum index (CSI). By separating serum components by gradient polyacrylamide gel electrophoresis, staining and quantitating these proteins by scanning densitometry, and dividing the area of AGP by that of PAB, indices can be obtained. In a test of sera from 450 patients with prostatic cancer, other urologic problems, and normal controls, CSIs of 360 sera presently decoded were found to be: (Formula: see text). The CSI should prove highly valuable when used in combination with selected prostatic cancer tests.

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The effect of serum protein concentrations on the specificity of the radioimmunoassay of carcinoembryonic antigen in malignant neoplasia and non-neoplastic disease

Cited by 9 publications

References 12 publications

Correlations among serum protein-bound carbohydrates, serum glycoproteins, lymphocyte reactivity, and tumor burden in cancer patients

Correlations among serum protein-bound carbohydrates, serum glycoproteins, lymphocyte reactivity, and tumor burden in cancer patients

The disparity of indirect and direct zirconylgel assays for carcinoembryonic antigen

Cancer serum index: A useful nonspecific test as a parameter in multimodality screening and assessment of patients with cancer of the prostate

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