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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