The clinical value of immunohistochemically demonstrable CEA in breast cancer: a possible method of selecting patients for adjuvant chemotherapy

Abstract

Summary.-The production of carcinoembryonic antigen (CEA) by human breast cancer tissue has been studied in relation to the prognosis of patients with breast cancer. All of the patients were in a controlled trial of adjuvant chemotherapy for the treatment of operable breast cancer. CEA was studied in primary tumours and axillary node metastases from these patients using an immunoperoxidase (PAP) method. Sections of 290 primary carcinomas and 217 axillary metastases were examined for CEA. The CEA status of the primary tumours was of no value as a prognostic indicator nor in the selection of patients for chemotherapy. In contrast, patients could be divided into 3 groups on the basis of the CEA results in the axillary nodes. In one group, in which cases were strongly positive for CEA (24% of the total) the prognosis, as reflected by recurrence free survival, was relatively good and chemotherapy produced no further advantage. In another group in which cases were weakly positive for CEA (18% of the total) the prognosis was poor but chemotherapy produced significant improvement. In a third group, in which cases were negative for CEA (58% of the total) the prognosis was poor and was not improved by chemotherapy, at least in the short term. Thus, the CEA status of axillary metastases may be clinically useful.

Significance of serum and tissue carcinoembryonic antigen for the prognosis of gastric carcinoma patients

“…A possible explanation for the observed relationship between primary tumor CEA status and prognosis is suggested by the widely accepted concept [40] that the presence of CEA may be associated with the behavior of malignant cells. Smith et al [12] reported another reason; CEA-negative cases showed a good response to chemotherapy.…”

“…The diagnostic value of CEA concentration in patients suspected of having a tumor is well established [8,9]. Several workers have studied the correlation between prognosis and CEA staining in lung [10] and breast carcinoma [11,12]. When CEA levels are positive in gastric carcinoma patients, they could be a useful prognostic indicator.…”

The prognostic significance of two epithelial membrane antigens expressed by human mammary carcinomas

“…The loss of the MN antigen has similarly been reported to be as-sociated with poor prognosis (Springer et al 1976) and again this may reflect an aberrant or incomplete processing of carbohydrate side chains of membrane components. Carcinoembryonic antigen expression is not related to recurrence-free survival in mammary carcinoma (Smith et al, 1982). In the present study the antigens detected are involved in the expression of a differentiated function in the mammary gland.…”