A Review of the Significance in Measuring Preoperative and Postoperative Carcinoembryonic Antigen (CEA) Values in Patients with Medullary Thyroid Carcinoma (MTC)

Abstract

Background and Objectives: Medullary thyroid carcinoma (MTC) accounts for 1–2% of all thyroid malignancies, and it originates from parafollicular “C” cells. Carcinoembryonic antigen (CEA) is a tumor marker, mainly for gastrointestinal malignancies. There are references in literature where elevated CEA levels may be the first finding in MTC. The aim of this study is to determine the importance of measuring preoperative and postoperative CEA values in patients with MTC and to define the clinical significance of the correlation between CEA and the origin of C cells. Materials and Methods: The existing and relevant literature was reviewed by searching for articles and specific keywords in the scientific databases of PubMedCentraland Google Scholar (till December 2020). Results: CEA has found its place, especially at the preoperative level, in the diagnostic approach of MTC. Preoperative CEA values >30 ng/mL indicate extra-thyroid disease, while CEA values >100 ng/mL are associated with lymph node involvement and distant metastases. The increase in CEA values preoperatively is associated with larger size of primary tumor, presence of lymph nodes, distant metastases and a poorer prognosis. The clinical significance of CEA values for the surgeon is the optimal planning of surgical treatment. In the recent literature, C cells seem to originate from the endoderm of the primitive anterior gut at the ultimobranchial bodies’ level. Conclusions: Although CEA is not a specific biomarker of the disease in MTC, itsmeasurement is useful in assessing the progression of the disease. The embryonic origin of C cells could explain the increased CEA values in MTC.

Nomogram for Predicting Lateral Lymph Node Metastasis in Medullary Thyroid Carcinoma: A Retrospective Cohort Study of Single Clinical Center

“…The clinical implications of lower CEA concentrations are unclear [4]. However, as Passos et al [10] shown, preoperative CEA values > 30 ng/mL indicated extra-thyroid disease, while CEA values > 100 ng/mL are associated with lymph node involvement and distant metastases. Ye et al [7] recommended that the cutoff of serum CEA for predicting LLNM of MTC patients was 29.8 ng/mL, with the AUC up to 0.831 (Sensitivity 75.0%, Speci city 81.57%).…”

The dual-crosslinked prospective values of RAI14 for the diagnosis and chemosurveillance in triple negative breast cancer

“…And the high expression of CA15-3 in the cell membrane and cytoplasm, as well as abnormally high serum concentrations, were seen in TNBC [ 46 ]. CEA belongs to the family of cell surface glycoproteins that plays an important role in cell adhesion [ 47 ] and elevated levels can be observed in a wide range of tumors, including BC. However, there were no apparent differences in the concentrations of CA15-3 and CEA at the beginning of BC [ 48 ].…”

Oncologic outcomes of calcitonin-negative medullary thyroid carcinoma

“…In a recent review, it was found that preoperative CEA values >30 ng/mL were indicative of extra-thyroid disease, while CEA values >100 ng/mL were related to lymph node involvement and distant metastasis. Furthermore, increase in the preoperative CEA values was associated with presence of lymph node metastasis or distant metastasis, larger size of the primary tumor, and a poorer prognosis ( 21 ). It has also been shown that serum CEA levels in typical MTC are significantly higher than those in Ct-negative MTC.…”