Quantitation of carcinoembryonic antigen in the lung lining fluid of normal smokers and nonsmokers.

Bronchoalveolar lavage was performed in 47 volunteers: 19 nonsmokers and 28 smokers. Total protein, albumin, immunoglobulins G and A, and carcinoembryonic antigen (CEA) were measured in the concentrated lavage effluent. Although a significant increase (p < 0.001) in the ratio of CEA to total protein recovered from the group of smokers was found, this increase primarily reflected the greater increase that occurred in a subgroup of 7 smokers. However, the increases in lavage CEA correlated weakly (p = 0.096) with smoking history in pack-years, and not at all with plasma CEA concentrations. Results regarding the number of cells recovered and immunoglobulin-to-albumin concentration ratios in these subjects were similar to those reported by others. Thus, CEA was increased in the lavage fluid of a subgroup of otherwise normal young smokers. It is possible that CEA might serve as a useful indicator of future airway disease in certain young smokers.

Carcinoembryonic antigen-like substance derived from human prostate.

Carcinoembryonic antigen-like substance, previously detected in large amounts in the medium from cultures of human prostatic epithelial cells, also is present in extracts of benign and malignant human prostate. By column chromatography, the prostate-derived carcinoembryonic antigen-like substance derived from cultured prostate is the same as that in tissue extracts and is distinctly different from colon-derived carcinoembryonic antigen. The molecular weight of prostate-derived carcinoembryonic antigen-like substance is estimated to be greater than 5 x 10(5). Prostate-derived carcinoembryonic antigen-like substance may be a prostate-specific substance.

Evaluation of carcinoembryonic antigen as a plasma monitor for human breast carcinoma.

Plasma CEA levels have been determined in 92 normal women and 768 women with benign or malignant breast diseases. Only one of 92 normal women had a CEA level above 5 ng/ml. Of 253 women with benign breast diseases (gross cystic disease, adenofibroma, fibrosis, etc.) only one had a CEA level above 5 ng/ml. Ninety-four percent of the above two groups of women had CEA levels below 3 ng/ml. Of 164 women operated upon for Columbia Clinical Classification Stage A or B breast carcinoma, preoperative CEA levels were above 5 ng/ml in seven (4%). Patients with a preoperative CEA level above 3 ng/ml seemed to have an increased incidence of tumor recurrence. Elevated CEA levels (greater than 10 ng/ml) in our postmastectomy population of 288 patients have correlated with development of metastases in 14 of 46 subjects. Of 216 patients under treatment for metastatic breast carcinoma, CEA levels above 10 ng/ml have been detected in 15 percent of patients with soft tissue metastases, 38% of patients with visceral metastases and 50% of patients with osseous metastases. Of metastatic breast carcinoma patients with CEA levels above 10 ng/ml serial measurements have correlated with the patients response to therapy, progressively increasing in treatment failures and decreasing in treatment responders.

Carcinoembryonic antigen (CEA) in the cancer family syndrome.

We present findings on plasma CEA in relatives and spouses from six kindreds manifesting the Cancer Family syndrome. The CEA distributions per se were transformed to square root CEA to correct for skewness and kurtosis. Significant effects of age and duration of smoking were adjusted for by linear regression. Relatives were classified as: 1) cancer patients, 2) individuals at high genetic cancer risk (one or more first-degree relatives affected, and 3) individuals at low genetic cancer risk (no first-degree relatives affected) for statistical comparisons. Unrelated spouses were also classified into corresponding groups according to their directline mate's status. Cancer patients and relatives at high genetic risk had significantly greater mean square root CEA than relatives at low genetic risk, and, surprisingly, unrelated spouses had mean levels of square root CEA which were similar to that in the corresponding cancer risk class of their direct-line mates. Our results suggest the existence of both a genetic and connubial effect on CEA, presumably due to a common environmental agent acting in concert with the degree of genetic predisposition to oncogenesis in this syndrome.

The clinical value of urinary carcinoembryonic antigen-like substances in urothelial cancer.

Although there is a positive correlation between the concentration of urinary carcinoembryonic antigen-like substances and urothelial cancer the clinical value of this association is in doubt. Urinary carcinoembryonic antigen values have been determined in large numbers of specimens from patients with a variety of urologic diseases but most studies have recorded only single measurements at the time of diagnosis. We examined the role of carcinoembryonic antigen in urothelial malignancies by comparing serial carcinoembryonic antigen, and cytologic and histologic analyses done on simultaneously collected urine and tissue specimens. We were particularly interested in the value of carcinoembryonic antigen as a diagnostic adjunct to cytology in low grade carcinoma and dysplasia, and the role of serial measurements of this substance in followup. The results of 102 analyses in 48 patients during a 15-month period indicate that urinary carcinoembryonic antigen measurements have little value in the diagnosis of bladder cancer, are of limited usefulness in combination with cytologic studies and are poorly correlated with simultaneously determined cytologic and histologic findings. Although the initial results were not promising serial measurements may be useful in followup.

Determination of baseline values for urinary carcinoembryonic antigen-like substances.

Carcinoembryonic antigen-like substances were measured in urine samples from 236 apparently healthy, asymptomatic individuals. Twenty-four-hour collections were submitted by 177 subjects, and random specimens were collected from 59 others. In addition to CEA measurements, bacterial colony counts and cytologic examinations were performed on the latter. Baseline values were established for males and females and data were analyzed for the effects of age, smoking, time of collection, and bacterial colonization. Results indicated that levels of CEA-like substances in the urine could be greatly altered by bacterial conlonization. Lesser effects were noted with age and time of collection. Smoking had no demonstrable effect. These variables should be considered for meaningful interpretation of urinary CEA values of patients suspected of urothelial malignancy.

CEA levels in fluids bathing gastrointestinal tumors.

A controlled prospective study was undertaken to determine if fluids which bathe malignancies may contain carcinoembryonic antigen (CEA) earlier in the course of gastrointestinal cancer than does plasma of the same patient and may offer a better means for diagnosis. CEA titers were normal (less than 2.5 ng per ml) in the plasma of 42 healthy volunteers. Normal CEA levels were also found in the plasma and in the colonic mucus of 14, the gastric juice of 18, duodenal drainage of 10, and bile of 11 normal control subjects. The colonic mucus of 3 patients with ulcerative colitis, gastric secretions of 5 benign gastric ulcer patients, bile specimens from 11 normal control subjects and from 5 gallstone patients contained CEA at concentrations below 2.5 ng per ml. Positive CEA titers were found in the fluids bathing tumors of all 23 patients with colonic carcinoma, 9 of 17 patients with gastric carcinoma, and all 6 patients with pancreatic carcinoma. In contrast, positive CEA titers were found in the plasma of only 16 of 23 patients with colon carcinoma, 6 of 17 patients with gastric carcinoma, and 4 of 6 patients with pancreatic carcinoma. Among 46 patients with gastrointestinal malignancies, CEA was detected in significant concentrations in the plasma of 26 patients and in fluids bathing tumors of 38 patients. These results indicate a significant association of adenocarcinoma of the colon with CEA-positive colonic mucus (P less than 0.01) and suggest the usefulness of assaying CEA in fluids bathing tumors for the detection of gastrointestinal malignancies.