Cea and nca in amniotic fluid of normal and abnormal pregnancies

Abstract

Carcinoembryonic antigen and cross-reacting NCA were demonstrated in 413 amniotic fluid samples representing different stages of pregnancy. Radioimmunoassay of CEA showed a decrease from a mean of 79 ng/ml at 19 weeks to 50 ng/ml near term. NCA, on the other hand, increased slightly from 184 ng/ml at 19 weeks to 219 ng/ml in the terminal part of pregnancy. There was a considerable interindividual variation of both substances at each time period. The NCNCEA quotient increased from 2.5 at 19 weeks to 4.9 at the end of gestation, but the variation precluded its use as a maturation index. The correlations between CEA, NCA, NCNCEA and alpha-fetoprotein levels and the lecithin/ sphingomyelin ratio were studied. The best correlations were found between CEA and NCA levels (r, = 0.52) and between CEA and AFP levels (r, = 0.46). CEA values deviating from the mean 2 2 SD were found in 3 out of 12 samples from fetuses with chromosomal aberrations, and in 3 out of 15 samples from pregnancies with fetuses considered small for date. Two patients with missed abortions both had NCA values outside the normal range. The quotient NCN CEA was lower than expected in two out of four patients with diabetes. Raised AFP levels were found in all ten pregnancies with neural tube defects and in two out of seven patients with chromosomal aberrations.Cancer 42:1579-1584, 1978.ARCINOEMBRYONIC ANTIGEN (CEA), which C is found in and has been characterized from tumors of the gastrointestinal tra~t.~,*,l" has been described to occur in endodermal fetal tissue7 and in amniotic fluid."14 Since a high CEA content can be found in meconiumg and raised values are found in discolored amniotic fluids,5 amniotic CEA may derive mainly from the gut of the fetus. CEA is found in low amounts in the adult gut1' and has been thought to be replaced with nonspecific crossreacting antigen (NCA).13,15 A radioimmunoassay of NCA was therefore used to assess the possible presence of NCA and any variations in this during pregnancy. Alpha-fetoprotein (AFP) has been demonstrated in human fetal liver and yolk sac and is presumably filtered to the amniotic fluid. Raised amniotic AFP is encountered in certain Accepted for publication September 8, 1977. fetal malformations.1~3~21.23.24 In nonpregnant subjects, raised serum values can be seen in tumors of hepatic or germ cell origin.' Fetal proteins are of interest as differentiation products and might therefore be useful as markers of maturity. It was accordingly decided to study the relation between known fetal substances during ontogenesis. Normal values of CEA, NCA and AFP in amniotic fluid at different gestational ages were determined, using specific antisera. Amniotic fluids from abnormal pregnancies were then studied for possible deviations from normal. MATERIALS A N D METHODS Clinical MaterialThe total material consisted of 413 samples collected at the Department of Obstetrics and Gynaecology at the Karolinska Hospital, Stockholm. Of these, 24 were serial samples from 11 patients. Pregnancies were classified as nor...

Non-specific cross-reacting antigen (NCA) in individual maturation stages of myelocytic cell series

“…Seventeen AML cases were studied, which were classified according to the proposal of the FABCooperative Group (Bennet et al, 1976 The specific anti-CEA and anti-NCA sera were prepared by immunizing goats with purified CEA (Zawadzka et al, 1979) or NCA (Krop-Watorek et al, 1983) as described previously (Harkozinska et al, 1983;Kula et al, 1983 Serum NCA levels were assayed by radioimmunoassay (Gadler et al, 1978).…”

Clinical evaluation of NCA in patients with chronic myelocytic leukemia

“…NCA was purified from human liver metastasis of adenocarcinoma of the colon, and 50 pg labelled with 2 mCi lB1 (Gadler et al, 1978;Wahren et al, 1980). For antibody determinations, 100 pl of human serum dilutions or rabbit anti-NCA antibody were incubated overnight with 100 pl lBI-labelled NCA.…”

“…The antigen was determined by a double-antibody assay previously described (Gadler et al, 1978;Wahren et al, 1980). A 50% inhibition of the NCA anti-NCA reaction was obtained with 5 ng NCA but not with >1,000 ng CEA or BGPI (Svenberg et al, 1979;Gadler et al, 1978). The assay has an interassay coefficient of variation of <15 %.…”

“…Lung and spleen in the healthy adult contain NCA, due to their content of alveolar macrophages and granulocytes (Burtin et al, 1975;Heumann et al, 1979). A radioimmunoassay has been developed (Gadler et al, 1978) that specifically measures NCA without cross-interference of CEA or BGPI, another CEA-related glycoprotein. Furthermore, measurement of NCA in individual blood cells by microimmunofluorometry has yielded data for myeloid cells .…”

Distribution of tumor‐associated antigen cea and cross‐reacting NCA in fetal organs

“…The similarity between cells during ontogenesis and tumor cells makes it worthwhile to study the behavior of tumor markers during the fetal period. We have analysed amniotic fluid from more than 400 normal and abnormal pregnancies (Gadler et al, 1977(Gadler et al, , 1978. The normal ranges have been established for different periods of gestation.…”