Thursday, June 14, 2012

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Carcinoembryonic antigen (CEA) - Causes of elevated level

CEA is an oncofetal antigen, a glycoprotein that is usually produced only during fetal life and is not present in the healthy adult blood. It is associated with certain malignancies, particularly epithelial tumors. It is a very non-specific tumour marker.


Normal values:
Non-smokers: 0–3 ng/mL [μg/L]
Smokers: 0-5 ng/mL [μg/L]


Elevated levels in: 
1) Adenocarcinoma of colon cancer (72%) (right side of colon>left side), 
2) Pancreatic cancer (91%), 
3) Lung cancer (76%), 
4) Stomach cancer (61%), 
5) Breast cancer, 
6) Cancer of ovary, 
7) Cholangiocarcinoma, 
8) Gall bladder cancer.

Other non-neoplastic conditions include: 
1) Cigarette smokers, 
2) Benign liver disease (acute 50% and chronic 90%), 
3) Benign GI disease (peptic ulcer, pancreatitis, colitis,cholecystitis).

Elevations >20 ng/mL are generally associated with malignancy and metastasis.

Screening: 
The test is not sensitive or specific enough to be useful in cancer screening.

Monitoring after surgery: 
It is better used as an indicator for monitoring treatment e.g. to follow progression of colon cancer after surgery (elevated CEA levels suggest recurrence 3–6 months before other clinical indicators).

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