Study of Carcinoembryonic Antigen Tissue Expression in Colorectal Cancer

Abstract

Aim:The aim of our study was to determine to what extent serial carcinoembryonic antigen (CEA) is helpful in detecting colorectal cancer recurrence. Second major objectives of this study were to evaluate tissue staining with CEA monoclonal antibody and its pattern of distribution in malignant tissue as regards its relation to prognostic value.Patients and Methods: 30 colorectal cancer patients undergoing clinically curative operations were studied. Primary tumors were evaluated for tissue CEA using immunohistochemical staining with CEA monoclonal antibody. Preoperative serum CEA level was measured as well as in follow-up monitoring of the patients. Results:The exact preoperative serum CEA value did not correlate with tumor stage, grade and immunohistochemical intensity or pattern. In the ten patients who developed recurrent cancer, the serum CEA at recurrence was greater than 5 ng/ml in 80%. All such patients with recurrent tumor had CEA present in their primary tumor.There was no correlation with exact preoperative serum CEA, the intensity of the primary tissue CEA, or localization of such CEA. Conclusion:Tissue CEA is a useful marker in prediction of tumor recurrence. Also serum CEA is a useful marker in detection of recurrent colorectal cancer. ZusammenfassungZielsetzung: Das Ziel unserer Untersuchung war die Bestimmung, inwieweit serienmäßiges karzinoembryonales Antigen (CEA) bei der Entdeckung von kolorektalen Karzinomrezidiven hilfreich ist. Die zweite große Zielsetzung dieser Untersuchung war die Bewertung von Gewebeeinfärbungen mit monoklonalen CEA-Antikörpern und ihrem Verteilungsmuster in malignem Gewebe im Hinblick auf ihren Voraussagewert.Patienten und Methoden: Wir untersuchten 30 Patienten mit kolorektalen Karzinomen, die sich klinisch kurativen Operationen unterzogen. Primärtumoren wurden im Hinblick auf das Gewebe-CEA mittels immunhistochemischer Einfärbungen mit monoklonalen CEA-Antikörpern bewertet. Die CEA-Serumspiegel wurden präoperativ ebenso gemessen wie bei den folgenden Nachuntersuchungen der Patienten.Ergebnisse: Die genauen präoperativen CEA-Serumwerte korrelierten nicht mit dem Tumorstadium, dem Tumorgrad und der immunhistochemischen Stärke oder dem Muster. Bei 80% der zehn Patienten, die ein Rezidiv entwickelten, war der CEA-Serumspiegel zum Rezidivzeitpunkt höher als 5 ng/ml. Bei allen Patienten mit einen Tumorrezidiv war zum Zeitpunkt des Primärtumors CEA vorhanden. Es bestand keine Korrelation mit dem genauen Serum-CEA, der Intensität des primären Gewebe-CEA oder der Lokalisation des CEA.Schlussfolgerung: Gewebe-CEA ist ein nützlicher Marker bei der Vorhersage eines Tumorrezidivs. Das Serum-CEA ist ebenfalls ein nützlicher Marker bei der Entdeckung von rezidivierenden kolorektalen Karzinomen.

Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer

“…In agreement with previous studies, the present study showed that both high-intensity t-CEA expression and the DC pattern were significantly associated with higher tumor recurrence rates 29 , 34 . Preoperative s-CEA concentration is also related to higher recurrence rates, as confirmed in the present study.…”

“…The present study found that t-CEA expression intensity and pattern correlated significantly with preoperative s-CEA level. Although many previous studies have reported a lack of correlation between preoperative s-CEA levels and t-CEA expression 29 , 30 , 33 , 34 , one study confirmed this relationship 35 . These discrepancies may be due to differences in categorization of t-CEA expression patterns and intensities, and the small populations sizes (30–517 patients) in these studies.…”

“…The DC pattern and high levels of expression have been associated with tumor aggressiveness, including LVI 26 . Studies have suggested that the DC pattern is associated with higher preoperative s-CEA levels, higher rates of lymph node and liver metastases, and higher recurrence and lower survival rates than the AL pattern 26 – 29 , although contradictory findings have also been reported 30 .…”