Assessment Of Carcinoembryonic Antigen Research Articles

Assessment of carcinoembryonic antigen as a prognostic marker in ovarian malignancies treated in a rural hospital of West Bengal

Background: Ovarian neoplasms are the second most common cause of gynecological malignancy both worldwide as well as in India. Innocuous clinical presentation and late diagnosis contribute to the mortality toll of this neoplasm. Thus, early diagnosis remains the cornerstone to increase the survival rate of ovarian neoplasms. Though, cancer antigen 125 (CA-125) is a time-tested marker for ovarian neoplasm diagnosis yet its increment in benign gynecological conditions questions its own diagnostic specificity. Carcinoembryonic antigen (CEA), the conventional marker for colorectal cancer detection, is found to be associated with epithelial ovarian cancer. Aims and Objectives: This study was aimed to find the efficacy of CEA along with CA-125 in the early detection of ovarian neoplasm and predicting the outcome. Materials and Methods: This hospital-based longitudinal study was conducted in the Biochemistry department of Bankura Sammilani Medical College. Established cases of ovarian neoplasm were recruited as study population using pre-defined inclusion and exclusion criteria. Serum CEA and CA-125 were estimated at the time of diagnosis, 6 weeks, 6 months, and 12 months after surgery. Results: There was no significant difference between the median concentration of CEA among the four phases of treatment. Serum CEA was positively correlated to CA-125 during all phases of treatment (Ρ=0.653, P=0.000). The binary logistic regression revealed that CEA (odds ratio=1.2, 0.83–1.69) had higher chances to be associated with ovarian stages associated with cancers beyond Stage IC. CEA had a lower sensitivity and specificity in comparison to CA-125. Conclusion: This study suggested CEA, a theranostic marker, can supplement the present biochemical diagnostic modalities to improve diagnostic and prognostic efficacy cost-effectively.

Evidence-based follow-up in colorectal cancer—quo vadis?

SummaryColorectal cancer is the third most common and the third most lethal cancer disease in the western world. As most patients undergo treatment with curative intent at initial diagnosis, postoperative surveillance protocols have been established with the primary aim to detect possible disease recurrence in an early resectable stage. Various international guidelines recommend an intensive surveillance protocol over a 5-year time period. These guidelines are based on the reported significant benefit regarding overall patient survival, and on the observation that 90% of recurrences occur within the first 5 years following resection. Surveillance protocols include regular clinical examinations, measurement of the carcinoembryonic antigen, computed tomography scans and regular endoscopies. While there is plenty of evidence regarding the scheduling of endoscopies, the frequency of carcinoembryonic antigen measurements and computed tomography scans has been ever since under debate. The benefit of intensive compared to low frequency surveillance protocols regarding disease-specific survival has never been shown. Moreover, recent meta-analyses and randomized controlled trials challenge current guidelines. Intensive carcinoembryonic antigen assessment and computed tomography scan follow-up protocols seem to fail in generating better overall and disease-specific survival in colorectal cancer patients compared to less intensive surveillance strategies. This change over the last few decades parallels the treatment evolution of colorectal cancer from a primarily surgical to a multidisciplinary task. Instead of advocating a reduction of the follow-up intensity, these findings should stimulate the colorectal oncology field to move from a one-fits-all to a patient-centered surveillance.

Carcinoembryonic antigen assessment during the perioperative period in patients with colorectal cancer in Poland

Introduction. Carcinoembryonic antigen (CEA) concentration is often elevated during the course of colorectal cancer. Assessment of the CEA level in this group of patients is recommended pre- and post-surgery, during systemic therapy, and further follow-up. A high preoperative level of CEA is a negative prognostic factor. The aim of the study was to determine the prevalence of CEA evaluation in the perioperative diagnostics in patients with colorectal cancer in Poland. Materials and methods. The analysis included 620 patients with stage III colorectal cancer, who underwent radical surgery in five Polish oncological centres during 2000–2014. The analysis of the clinical practice concerning the determination of CEA was based on the available medical records involving the pre- and post-operative period. Results. The determination of the CEA level before the surgery was performed in only 200 patients (32%), and in 528 patients (85%) following resection and before starting the adjuvant systemic chemotherapy. In 74% of patients the preoperative CEA level exceeded 5 ng/mL (median 10.5 ng/mL; standard deviation 4.4–22.5). After the surgical procedure in more than 85% of patients the CEA level was within to the recommended normal value of 5 mg/mL (median 1.9; standard deviation 1.1–3.4). Conclusions. Preoperative CEA level is scarcely determined in patients with colorectal cancer in Polish centres, which may impede further monitoring of the disease course. These results suggest the need for better adherence to the recommendations concerning the pre- and postoperative diagnostics in this group of patients.

The distinction of adenocarcinoma from malignant mesothelioma in cell blocks of effusions: The role of routine mucin histochemistry and immunohistochemical assessment of carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, and milk fat globule-derived antigen

The distinction of adenocarcinoma from malignant mesothelioma in cell blocks of effusions: The role of routine mucin histochemistry and immunohistochemical assessment of carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, and milk fat globule-derived antigen