Carcinoembryonic antigen in gastric juice collected during endoscopy. Value in detecting high-risk patients and gastric cancer

Abstract

In order to ascertain the role of gastric carcinoembryonic antigen (CEA) determination in detecting patients with a risk for gastric cancer, 69 subjects were studied; 23 were referred for endoscopy because of dyspepsia but without obvious macroscopic lesions, 27 with duodenal ulcer, 11 with benign gastric ulcer, 8 with gastric cancer. The following results were obtained by subdividing the material according to the histologic interpretation of the results of gastric mucosal biopsies: (1) in the presence of minor histologic abnormalities of the gastric mucosa, CEA in gastric juice was under 100 ng/ml in all but five cases; and (2) in moderate or severe chronic atrophic gastritis (associated or otherwise with intestinal metaplasia or dysplasia), and in gastric cancer, gastric CEA ranged between 224 and 3120 ng/ml in all but two cases. Although not diagnostic for gastric cancer, gastric CEA is a promising test in detecting patients at risk, including those with dysplasia of the gastric mucosa. Cancer 52:2334‐2337, 1983.

Evaluation of gastric carcinoembryonic antigen analysis as an aid during screening for gastric neoplasia in atrophic gastritis.

“…Of all 61 patients with atrophic gastritis, 53 (87%) With regard to the local CEA concentrations, the results of this study agree with those of others,7 21 and it was also shown that gastric juice CEA levels do not differ between patients with gastric adenocarcinoma and patients with pronounced atrophic gastritis.7 18 21 Mucosal CEA analysis showed a low sensitivity for atrophic gastritis or atrophic gastritis with superimposed lesions. Tissue CEA concentrations in the fundic mucosa were, to some extent, positively related to the gastric juice CEA concentrations, indicating that the gastric mucosal production of CEA is reflected in the gastric juice CEA content.…”

The role of serum and gastric juice levels of carcinoembryonic antigen, CA19.9 and CA72.4 in patients with gastric cancer

“…Although the presence of CEA, CA19.9, and CA72.4 in the gastric juice has been suggested to be a parameter for the identi®cation of populations at risk and early tumor detection (Bunn et al 1979;Farinati et al 1988;Harrison et al 1989;Nitti et al 1983;Tatsuta et al 1980Tatsuta et al , 1988Tong and Wei-wen 1988), the low sensitivity of serum-positive markers means that they play a secondary diagnostic role (Hakama et al 1994;Norton and Fraker 1997;Posner and Mayer 1994;Roulston 1990;Schwartz 1993). Results of our study on the percentage of marker positivity, although slightly higher, compare well with those reported in the literature, in both the serum and gastric juice, and con®rm that markers, when considered separately play a poor diagnostic role in gastric cancer patients.…”

“…After thawing, the pH of gastric juice was measured again and adjusted to 7 with sodium bicarbonate buer. The technique was similar to that described by Tatsuta et al (1980) and Nitti et al (1983). Serum and gastric juice CEA, CA19.9, and CA72.4 levels were determined by immunoradiometric assay using CIS RIA MoAb-Centocor kits (CIS International, Gif-sur-Yvette, Cedex, France).…”

CA 50 Determination in body fluids: Can we screen patients at risk for gastric cancer?

“…As a rule, better results have been obtained by testing gastric juice, either with respect to CEA (Runn et al, 1979;Tatsuta et al, 1988;Graffner et al, 1983;Fujimoto et al, 1979;Satake et al, 1980) or other cancer markers (Farinati et al, 1988;Hakkinen, 1980). Although pitfalls are possible due to sampling or methodological errors (Gion et al, 1988), the tests carried out in gastric juice are usually reliable not only in identifying patients with gastric cancer but also in separating those "at risk" for cancer (Nitti et al, 1983;Tatsuta et al, 1988;Castelli et al, 1986;Farinati et al, 1988). As they are susceptible to the presence of gastric cancer and gastric precancerous changes but not to other factors, such as age, they have been proposed for screening in high-incidence areas (Winawer, 1979).…”

“…Among the many markers proposed are CEA (Ellis et al, 1978), gastro-intestinal carcinoma-associated antigen (Safi et al, 1987;Quentmeier et al, 1987), Ca 12-5 (Quentmeier et al, 1987(Quentmeier et al, , 1986. In general, better results have been obtained by testing gastric juice rather than serum for these oncofetal antigens (Bunn et al, 1979;Tatsuta et al, 1980;Nitti et al, 1983;Tatsuta et al, 1988;Castelli et al, 1986;Farinati et al, 1988;Graffner et al, 1983;Hakkinen et al, 1980). Gastric juice oncofetal antigen determination, due to direct shedding of antigens into the fluid around tumor tissues, appears to accurately indicate the presence and degree of gastric mucosal damage and to be to a slight extent influenced by unrelated factors (Farinati et al, 1986).…”