Simultaneous Gastric and Plasma Immunoreactive Plasma Carcinoembryonic Antigen in 108 Patients Undergoing Gastroscopy

Measuring Intragastric Tumor Markers in Gastric Cancer Patients: a Systematic Literature Review on Significance and Reliability

“…They also found no correlation between the gastric immunoreactive CEA and microscopic or macroscopic appearance of the tumor or the extent of disease (17). Nevertheless, the authors were so enthusiastic about the trend of their results that they encouraged future studies to perform gastric CEA for the screening and follow-up of patients at high risk for GC, identification of early relapse in gastrectomized patients and valuation of response to chemotherapy with or without surgery (17). Tatsuta and associates, reporting a study on 58 GC patients in 1980, were the first to assess that the determination of GJ CEA was not a good indicator of EGC because of the very low sensitivity of this test (46.6%): more importantly, in so doing, they definitely pointed at the imperfection and fallaciousness of gastric CEA just like serum CEA titers (18).…”

“…In 1979, Bunn and colleagues found far higher levels of intragastric CEA in GC patients than patients suffering from benign gastric diseases (respectively, 900 ng/ml for GC, 21.4 ng/ml for gastritis, 11.9 ng/ml for gastric ulcer, 7.3 ng/ml for duodenal ulcer) but this finding failed to reach statistical significance (17). They also found no correlation between the gastric immunoreactive CEA and microscopic or macroscopic appearance of the tumor or the extent of disease (17). Nevertheless, the authors were so enthusiastic about the trend of their results that they encouraged future studies to perform gastric CEA for the screening and follow-up of patients at high risk for GC, identification of early relapse in gastrectomized patients and valuation of response to chemotherapy with or without surgery (17).…”

“…Through the years, clinical laboratories improved the methods of determining intragastric tumor antigens changing from qualitative to quantitative detection method, from manual add sample to automatic detection, from ELISA to chemiluminescence. Regarding the determination of GJ/GL tumor markers of GC patients, only 19 dedicated works exist in the world literature so far and this field of oncologic research covers a very limited span of time (approximately 40 years) (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). The main features pertaining to the heritage of this scientific niche are summarized in Table I.…”

“…Carcinoembryonic antigen (CEA) represents the endogastric tumor marker which was first investigated by the medical community and the one better analyzed to date as witnessed by the large amount of dedicated works (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(26)(27)(28)(29)(30). Historically, CEA was immunohistochemically detected both in normal and neoplastic gastric mucosa in 1972, but it was not until 1975 that Go and colleagues pioneered the determination of CEA levels in gastrointestinal secretions (12).…”

“…They also introduced the utilization of "the one step sandwich method" by Hirai as radioimmunoassay test and, paralleling what Sugarbarker demonstrated in the large bowel because of obstructing colon cancer, suggested how endogastric or endoduodenal obstruction exerted by the tumor itself could augment the intragastric concentration of tumor markers (16). In 1979, Bunn and colleagues found far higher levels of intragastric CEA in GC patients than patients suffering from benign gastric diseases (respectively, 900 ng/ml for GC, 21.4 ng/ml for gastritis, 11.9 ng/ml for gastric ulcer, 7.3 ng/ml for duodenal ulcer) but this finding failed to reach statistical significance (17). They also found no correlation between the gastric immunoreactive CEA and microscopic or macroscopic appearance of the tumor or the extent of disease (17).…”