Carcinogenic Embryonic Antigen Research Articles

Immunological Analysis of Vestibular Schwannoma Patients.

Vestibular schwannoma is a benign intracranial tumor of the vestibulocochlear nerve. Although it is a well-known pathology, growth factors and cytokine changes in vestibular schwannoma patients have not been totally elucidated. The objective of our study was to evaluate the concentration changes of transforming growth factor beta1, vascular endothelial growth factor, immunoglobulins A, M, and carcinoembryonic antigen in vestibular schwannoma patients. In our study, we performed an immunological analysis of 35 patients with vestibular schwannoma of different stages. According to the evolution of vestibular schwannoma, 20 patients did not show tumor growth, but 15 patients had a growing tumor. The level of vascular endothelial growth factor in the blood serum of study groups exceeded the control values by 8 times and transforming growth factor beta1 by 1.65. Increased values of immunoglobulin A and immunoglobulin M were observed in patients with intracanal, second, and third stages of tumor, compared with the control group. Carcinoembryonic antigen was found to be of increased values in patients with intracanal and third-stage vestibular schwannoma, in comparison to the control group. Growth factors such as vascular endothelial growth factor and transforming growth factor beta1 can play a significant role in the genesis of vestibular schwannoma. In vestibular schwannoma patients, their investigation is appropriate both in the process of monitoring and in the assessment of treatment effectiveness. Immunoglobulins M and A can be used as additional markers of vestibular schwannoma, especially in tumor growth. Carcinogenic embryonic antigen has high values only in the late stages of vestibular schwannoma development.

Molecular Analysis of Pancreatic Cyst Fluid for the Management of Intraductal Papillary Mucinous Neoplasms.

Pancreatic cancer is one of the most lethal human cancers. Early detection and diagnosis of precursor lesions for pancreatic malignancy is essential to improve the morbidity and mortality associated with this diagnosis. Of the cystic precursor lesions, branch duct intraductal papillary mucinous neoplasm (IPMN) is the most frequently identified lesion and has a wide range of malignant potential. Currently, Carcinogenic embryonic antigen (CEA) levels in the cyst fluid and cytology are the two most often utilized tools to diagnose these lesions; however, their diagnostic and risk stratification capabilities are somewhat limited. Within the last decade, the use of endoscopic ultrasound-guided fine-needle aspiration has opened the door for molecular analysis of cystic fluid as an option to enhance both the diagnosis and risk stratification of these lesions. The first step is to differentiate branch duct IPMNs from other lesions. KRAS and GNAS alterations have been shown to be accurate markers for this purpose. Following cyst type identification, mutational analysis, telomere fusion, microRNAs, long non-coding RNA, and DNA methylation have been identified as potential targets for stratifying malignant potential using the cystic fluid. In this review, we will examine the various targets of cyst fluid molecular analysis and their utility in the diagnosis and risk stratification of branch duct IPMNs.

S2246 FIT or Unfit: Advanced Colon Cancer Screening

Introduction: Colorectal cancer (CRC) is the third leading cause of cancer related mortality worldwide. The U.S. Preventative Services Task Force guidelines recommend screening for average risk patients at age 45, and modalities include stool-based or direct visualization tests. We report a presentation of Stage IV colorectal adenocarcinoma in the setting of 3 annual negative fecal immunochemical testing (FIT) tests. Case Description/Methods: A 67-year-old woman presented with shortness of breath, unintentional weight loss, and abdominal pain. She denied hematochezia or melena. Physical exam was notable for pallor and right upper quadrant pain. Initial laboratory data showed normocytic anemia with a hemoglobin 10.1 g/dL, alkaline phosphatase 610 U/L, aspartate aminotransaminase 116 U/L, alanine aminotransaminase 67 U/L. Computed tomography of the chest, abdomen, and pelvis revealed a normal colon and extensive metastatic disease in the liver and lungs with bilateral subsegmental pulmonary emboli. Chart review was notable for negative FIT tests in 2017, 2018, and 2020, performed within a year of this presentation. Further workup was significant for elevated carcinogenic embryonic antigen 1470 ng/mL, and normal alpha-fetoprotein and cancer antigen 19-9 levels. Colonoscopy revealed an infiltrating, ulcerated, semi-circumferential mass at the ileo-cecal valve and ascending colon (Figure). Pathology demonstrated moderately differentiated invasive colonic adenocarcinoma with malignant glands infiltrating a desmoplastic stroma. Immunohistochemistry did not show any microsatellite instability changes. Discussion: One study showed FIT testing was 73.8% sensitive for detecting Stage I-III CRC, however, sensitivities dropped with advanced precancerous lesions and sessile serrated polyps to 23.8% and 5.1% respectively. Another retrospective cohort looking at 6 consecutive rounds of FIT testing demonstrated lower accuracy of detecting proximal colon cancers compared to distal cancers (0.45 vs 0.73; P< 0.001). Lower cut off values of qualitative FIT correlated with better sensitivities, however, specificity declined. Although FIT testing is able to detect the majority of colorectal cancers, it has decreased accuracy and sensitivity in advanced precancerous lesions, sessile serrated polyps, and proximal (right) colon lesions. Colonoscopy is considered gold standard and further guidelines should recommend a standardized cut off value to help improve screening efficacy.Figure 1.: Large fungating mass in the ascending colon and ileo-cecal valve.

Relationship between Serum Tumor-Related Markers and Genetically Modified Rice Expressing Cry1Ab Protein in Sprague-Dawley Rats

Genetically Modified (GM) foods are among the most important achievements of biotechnology. Given the safety importance of transgenic rice, this study was conducted to investigate the effect of GM rice consumption on serum concentrations of tumor markers in rats. In this experimental intervention, we used the blood serum samples from the Biobank taken from 60 males and 60 female Sprague-Dawley (SD) rats fed on three different diets, including rat’s standard food, non-GM rice, and GM rice after 90 day. Tumor markers including Carcinogenic embryonic antigen (CEA), Alpha-Fito protein (AFP), Cancer Antigen 19-9 (CA19-9), Cancer Antigen 125 (CA125), and Cancer Antigen15-3 (CA15-3) were assessed by enzyme-linked immune sorbent assay (ELISA) method. Statistical analysis was conducted via SPSS software. The results show that the concentrations of tumor markers were within the normal range in the SD rats treated with diet, and since the concentration of tumor markers was lower than the acceptable index determined, according to the kit standard in both groups, no obvious carcinogenic effect was found. However, these findings are not enough to make a final decision regarding the safety assessment of GM rice consumption.

Autonomous biosensing device merged with photovoltaic technology for cancer biomarker detection

Pursuing self-powered biosensors, this work describes a hybrid device combining a sensing electrochemical system with a photovoltaic cell. The sensing system is a molecularly-imprinted polymer (MIP) and the photovoltaic cell is a dye-sensitized solar cell (DSSC). The biosensing film is tailored on a typical counter electrode (CE) of a conventional DSSC, turning the resulting hybrid system sensitive to a target analyte. The target analyte selected herein was carcinogenic embryonic antigen (CEA), a typical cancer biomarker in colorectal cancer.In detail, the MIP film was tailored on a highly conductive polyaniline CE, by electropolymerizing aniline on top of it, in near basic pH and in the presence of CEA. The protein was later removed by proteinase K action. The resulting vacant sites were able to rebind CEA, as confirmed in a 3-electrodes set-up, by square-wave voltammetry (SWV) and electrochemical impedance spectroscopy (EIS) studies.The hybrid DSSC/biosensing system was tested by incubating the CEA solution in urine sample on the biosensing film and using the resulting surface to act as counter electrode of the photovoltaic cell. The photovoltaic features of the resulting device confirmed the dependency between power and CEA concentration. In this new set-up, a linear trend was observed between power and log CEA concentration, down to 0.025 ng mL−1 when urine samples were tested.Overall, the hybrid device is inexpensive and self-powered, which holds a great impact in point-of-care applications, especially in low-income countries. This concept may be further extended to other biomarkers implicated in several diseases or other target molecules involved in food safety or environmental monitoring needs.

Biomimetic materials assembled on a photovoltaic cell as a novel biosensing approach to cancer biomarker detection

This work describes for the first time the integration of Dye Sensitized Solar Cell (DSSC) technology in biosensors and biomimetic materials, opening doors towards a new dimension of autonomous screening devices that may be used in point-of-care, with zero-power requirements. DSSCs are fabricated with a counter electrode (CE) of polypyrrole (PPy) that was made responsive to a specific protein by biomimetic material (BM) technology. Carcinogenic embryonic antigen (CEA) was selected as target protein. The resulting BM-PPy film acted as biomimetic artificial antibody for CEA. Rebinding of CEA into this film changed its intrinsic electrical properties and the subsequent electrical output of the DSSC using it as CE. The quantity of CEA in solution was deduced by I-V and electrochemical impedance spesctroscopy (EIS). Linear responses to CEA were observed down to 0.25 pg/mL, with 0.13 pg/mL detection limit. Control films of PPy (prepared without CEA in the electropolymerization step) confirmed the ability of the BM material to recognize the target protein. Accurate results were obtained in the analysis of urine samples. Further developments into this ground-breaking self-powered biosensor will display a huge impact in point-to-care medical applications, which may be extended to other fields of knowledge.

541P - Role of cancer ratio and carcinogenic embryonic antigen ratio in diagnosis of pleural effusion

Background: Pleural effusion results from either malignant or nonmalignant conditions, cytological examination of pleural fluid is diagnostic only in about 50% of malignant pleural effusions. Cancer ratio (serum serum lactate dehydrogenase (LDH)/pleural adenosine deaminase (ADA) may be helpfull in cancer diagnosis of patients with exudative pleural effusion, we investigated this issue along with CEA ratio (pleural CEA/serum CEA) Methods: This study included 60 patients referred to Clinical Oncology & Nuclear Medicine and Chest Departments Menoufia University hospital in the period from January 2016 to January 2017 presented with exudative pleural effusion the mean age was 67.20 + 11.12. 33 patients out of 60 were males and 27 were females, patients were classified into 3 groups, group I included 20 patients with malignant plueral effusion, group II included 20 patients with tuberculous pleural effusion and group III included 20 patients with parapneumonic pleural effusion. The cancer patients group included stage IV disease: 10 patients had bronchogenic carcinoma, 2 patients had pleural mesothelioma, 5 patients had breast cancer and 3 patients with ovarian cancer. All patients underwent thoracentesis and cytology, Serum LDH, pleural ADA, serum and pleural CEA were done then data was statistically analyzed and the cut off value for cancer ratio and CEA ratio was done Results: Cancer ratio was significantly higher in the patients with malignant pleural effusion 59.32 ± 8.19 than the tuberculous group 5.72 ± .15 than patients with parapneumonic effusion 10.30 ± .79, (p < 0.001). CEA ratio was significantly higher in malignant group 4.17 ± .47 than parapnemonic group 2.88 ± .27 than tuberculous group 1.16 ± .08, (p < 0.001). 1 year survival in all patients was (86.6%) and in cancer patients group (80%), there was no statistically significant difference in survival between different primary cancer sites (P > 0.05). in all groups, the mean cancer ratio 19.8188 ± 3.41536 in survived patients compared with 59.5548 ± 18.51138 in non survived patients, the difference was significant (p < 0.01), also the mean CEA ratio 2.4238± .22462 in survived patients compared with 4.8050± .78987 in non survived patients (p < 0.01). Furthermore cancer ratio at cut off point (5.03) can discriminate malignant pleural effusion with sensitivity of 100% and a specificity of 87% while CEA ratio can detect malignant pleural effusion at cut off point (2.53) with sensitivity of 75% and a specificity of 40% Conclusions: Cancer ratio at cut off point (5.03) is a simple method which can discriminate malignant pleural effusion with sensitivity of 100% and a specificity of 87%. Legal entity responsible for the study: menoufia university Funding: None Disclosure: All authors have declared no conflicts of interest.

Role of cancer ratio and carcinogenic embryonic antigen ratio in diagnosis of pleural effusion

Role of cancer ratio and carcinogenic embryonic antigen ratio in diagnosis of pleural effusion

Redox cycling-based immunoassay for detection of carcinogenic embryonic antigen

Redox cycling based on an interdigitated electrode (IDE) was used as a highly sensitive immunoassay for carcinogenic embryonic antigen (CEA) through the quantification of 3,3′,5,5′-tetramethylbenzidine (TMB). For the redox cycling process, one pair of interdigitated finger electrodes was used as the first working electrode (generator) for cyclic voltammetry of TMB, and another pair of interdigitated finger electrodes was used as the second working electrode (collector) for sequential application of potentials for reduction and oxidation of TMB. The reduction (and oxidation) products of TMB at the collector were supplied to the generator, and following sequential oxidization (and reduction) at the generator, again supplied to the collector. Such redox recycling processes between the generator and collector allowed signal amplification. In this work, the influences of the following factors on the redox cycling of TMB were analyzed: (1) the redox potential at the collector, (2) the gap between the interdigitated finger electrodes, and (3) the scan rate of the generator. The redox potential and electrode gap influences were simulated with COMSOL software and compared with empirical results. At the optimum redox potentials and electrode gap, redox cycling was estimated to be five-fold more sensitive for the quantification of TMB than conventional cyclic voltammetry using one pair of interdigitated finger electrodes as the working electrode. Finally, redox cycling was applied to a commercial immunoassay for CEA, and the sensitivity of redox cycling was three-fold higher than that of conventional cyclic voltammetry using a single set of interdigitated finger electrodes as the working electrode.

Primary Hepatoid Adenocarcinoma of the Lung

ABSTRACT Hepatoid adenocarcinoma lung (HAL) is an extremely rare type of extrahepatic adenocarcinoma with morphological similarity to hepatocellular carcinoma. We report a case of 59 years male smoker who presented with anorexia, weight loss and cough. Chest X-ray revealed a homogenous opacity in the left upper and mid zone. Computed tomography (CT) chest showed a left upper lobe mass with enlarged hilar lymph nodes. Serum alpha fetoprotein (AFP) was normal. Guided fine needle aspiration cytology (FNAC) of the mass revealed a few atypical cells. Endobronchial biopsy showed sheets of polygonal cells with coarsely clumped chromatin, eosinophilic nucleoli and abundant eosinophilic to clear cytoplasm. The neoplastic cells were positive for hepatocyte-1, Carcinogenic embryonic antigen (CEA), Cytokeratin 7 (CK-7) and cytoplasmic positivity for thyroid transcription factor (TTF-1). After 3 months, the tumor had grown significantly. Due to its aggressive behavior, early and accurate diagnosis is necessary. How to cite this article Vellaisamy G, Rout P, Crasta J, Devaraj U. Primary Hepatoid Adenocarcinoma of the Lung. J Postgrad Med Edu Res 2016;50(2):103-106.

Screen-printed electrode produced by printed-circuit board technology. Application to cancer biomarker detection by means of plastic antibody as sensing material

This research work presents, for the first time, a screen-printed electrode (SPE) made on a PCB board with silver tracks (Ag) and a three electrode configuration (AgxO-working, AgxO-counter and Ag/AgxO-reference electrodes), following the same approach as printed-circuit boards (PCBs). This low cost and disposable device was tested for screening a cancer biomarker in point-of-care. The selected biomarker was carcinogenic embryonic antigen (CEA) protein, routinely used to follow-up the progression of specific cancer diseases.The biosensor was constructed by assembling a plastic antibody on the Ag-working electrode area, acting as the biorecognition element of the device. The protein molecules that were entrapped on the polymer and positioned at the outer surface of the polypyrrole (PPy) film were removed by protease action. The imprinting effect was tested by preparing non-imprinted (NPPy) material, including only PPy as biorecognition element. Infrared and Raman studies confirmed the surface modification of these electrodes. The ability of the sensing material to rebind CEA was measured by several electrochemical techniques: cyclic voltammetry (CV), impedance spectroscopy (EIS) and square wave voltammetry (SWV). The linear response ranged from 0.05 to 1.25pg/mL against logarithm concentration.Overall, producing screen-printed electrodes by means of conventional PCB technology showed promising features, mostly regarding cost and prompt availability. The plastic antibody-based biosensor also seems to be a promising tool for screening CEA in point-of-care, with low response time, low cost, good sensitivity and high stability.

Fisetin modulates mitochondrial enzymes and apoptotic signals in benzo(a)pyrene-induced lung cancer

The present study was aimed to delineate in vivo mechanisms of orally administered fisetin with special reference to mitochondrial dysfunction in lung tissues employing benzo(a)pyrene (B(a)P) as the model lung carcinogen. The recent revival of interest in the study of mitochondria has been stimulated by the evidence that genetic and/or metabolic alterations in this organelle lead to a variety of human diseases including cancer. These alterations could be either causative or contributing factors. Hence, the activities of mitochondrial-specific enzymes of isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, succinate dehydrogenase, malate dehydrogenase and tumor marker, carcinogenic embryonic antigen were analyzed in control and experimental groups of mice. The induction of apoptotic and anti-apoptotic proteins such as Bcl-2/Bax, cytochrome c, caspase-9 and caspase-3 was confirmed by the immunohistochemistry and Western blot analyses. Furthermore, transmission electron microscopy study of lung sections of B(a)P-induced mice showed the presence of phaemorphic cells with dense granules and increased mitochondria. All the aberrations were alleviated when the mice were treated with fisetin (25 mg/kg body weight). The results proved fisetin to be a very successful drug in combating the mitochondrial dysfunction in an experimental model of lung carcinogenesis induced by B(a)P.

Complete Response after Treatment with UFT/LV Regimen for Liver and Lung Metastases of Rectal Cancer: A Case Report

A 72-year-old woman was diagnosed with Borrmann type I and II tumors in the rectosigmoid colon by colonoscopy. Whole-body Computed Tomography (CT) revealed two 1-cm masses on both lungs; however, no mass was observed in the liver. The patient underwent low anterior resection for the treatment of colorectal cancer. One month after surgery, her serum Carcinogenic Embryonic Antigen levels had doubled (283 ng/mL) compared with that at surgery; therefore, contrast-enhanced CT revealed liver metastatic lesions at segments 2 and 5. For her advanced colorectal cancer with lung and liver metastases, five cycles of chemotherapy consisting of infusional irinotecan, l-LV, and a bolus injection of 5-FU on day 1 followed by oral UFT and LV on days 1-7 were continued until the patient could not endure the adverse effects in the gastrointestinal tract. This regimen was chosen with the intention of reducing the infusional administration of drugs. Subsequently, an oral regimen of UFT/LV was initiated at the outpatient clinic. Twelve months later, CT revealed the disappearance of lung and liver lesions, and her serum CEA levels had returned to normal; therefore, the patient was considered to exhibit a Complete Response (CR). The chemotherapy was subsequently discontinued at the patient’s request and she has maintained CR for over a year.

EUS for Pancreas Cysts: What Should We Be Sampling?

The growing resolution and more frequent use of imagingmethods has increasingly identified pancreatic cysts,ranging from benign serous and pseudocysts to premalig-nant or malignant mucinous cystic neoplasm (MCN). Dueto the disparate course and management of benign cystsversus cystic neoplasms or pre-neoplasms, unambiguouslesion identification is essential, which is not always pos-sible with conventional cross-sectional imaging [1]. Thus,an increasing number of centers are utilizing endoscopicultrasound (EUS) for further characterization of pancreaticcysts with high resolution images of cyst morphology, size,presence and type of septations, presence of solid compo-nents, and the ability to sample cyst contents using fineneedle aspiration (FNA) and to perform biopsies. Charac-teristics such as diameter[3 cm and the presence of muralnodules may be the best predictors of malignant transfor-mation of MCN or side-branch type intraductal papillaryneoplasms (SB-IPMN) [2]. In some cases, however, biopsyof solid material or aspiration of cyst fluid is essential toconfirm the diagnosis. Thus, when a pancreas cyst isdetected on CT or MRI, the clinical question often arises asto whether EUS should be performed and, furthermore, ifadditional FNA or biopsy is helpful.In this month’s issue of Digestive Diseases and Sci-ences, Lim et al. [3] report their findings in ‘‘Factorsdetermining diagnostic yield of EUS guided fine-needleaspiration for pancreatic cystic lesions: a multicenter Asianstudy.’’ The authors include a multicenter analysis of 298patients with diverse pancreatic cystic lesions who under-went EUS of whom 132 (44 %) underwent EUS–FNA.FNA cytology with a single pass was only 29 % when solidcomponents are not present. Furthermore, their studydemonstrated a higher yield (44 %) when solid componentswere biopsied during a single pass, which increased to78 % with multiple passes. Although biochemical markerssuch as carcinogenic embryonic antigen (CEA) and amy-lase measured in cyst fluid aspirates are frequently used toaid in diagnosis of pancreatic cysts, the authors focused oncytologic yield from EUS–FNA. In the literature, theoverall yield of EUS–FNA for cytologic analysis of inde-terminate pancreatic cystic lesions is 31–37 % [2, 4].Morphologic features noted by high resolution EUSimages of small pancreatic cysts can help differentiatemucinous-type cysts from others. Nevertheless, in a recentstudy, expert endosonographers were evaluated for theirability to make a diagnosis of pancreatic MCN based onEUS appearance alone without FNA. The accuracy wasonly 23–46 % despite the use septations, mural nodules,solid components, and communication with the pancreaticduct as criteria [5]. Therefore, FNA for fluid analysis orbiopsy of solid materials may add to diagnostic yield,particularly for indeterminate cysts. Solid material within acyst may represent debris but could also arise frommalignancy.Several studies have addressed the acquisition of pan-creatic cyst specimens and types of analysis that providethe highest diagnostic yield. Cytologic analysis of aspiratedfluid is usually of low yield due to the unlikelihood thatpancreatic cysts shed adequate cells for evaluation.Accordingly, a recent study demonstrated that FNA of thecyst wall rather than fluid aspiration alone can improvediagnostic yield up to 81 %, with the majority of casesdemonstrating mucinous epithelium [6]. Other investiga-tors have examined the use of a cytology brush passedthrough a 19-gauge FNA needle to gather more cellular

Serum Markers of Intrahepatic Cholangiocarcinoma

Cholangiocarcinoma (CCA) is a relatively rare type of primary liver cancer that originates in the bile duct epithelium. It is an aggressive malignancy typified by unresponsiveness to chemotherapy and radiotherapy. Despite advances in radiologic techniques and laboratory diagnostic test, the diagnosis of CCA remains highly challenging. Development in molecular techniques has led to go into the possible use of serum markers in diagnosing of cholangiocarcinoma. This review summarizes the principal characteristics of serum markers of cholangiocarcinoma. The tumour markers used frequently such as Carbohydrate antigen 19-9 (CA 19-9), Carcinogenic Embryonic antigen (CEA), and Cancer Antigen 125 have shown sufficient sensitivity and specificity to detect and monitor CCA. In particular, the combination of these tumour markers seems to increase their efficiency in diagnosing of cholangiocarcinoma. New markers such as Soluble fragment of cytokeratin 19 (CYFRA 21-1) Mucins, Tumour Markers2-pyruvate-Kinase (TuM2-PK) and metalloproteinase-7 (MMP-7) have been recently shown to help in the diagnosis of CCA, with in some cases a prognostic value.

Serum markers of intrahepatic cholangiocarcinoma.

Cholangiocarcinoma (CCA) is a relatively rare type of primary liver cancer that originates in the bile duct epithelium. It is an aggressive malignancy typified by unresponsiveness to chemotherapy and radiotherapy. Despite advances in radiologic techniques and laboratory diagnostic test, the diagnosis of CCA remains highly challenging. Development in molecular techniques has led to go into the possible use of serum markers in diagnosing of cholangiocarcinoma. This review summarizes the principal characteristics of serum markers of cholangiocarcinoma. The tumour markers used frequently such as Carbohydrate antigen 19-9 (CA 19-9), Carcinogenic Embryonic antigen (CEA), and Cancer Antigen 125 have shown sufficient sensitivity and specificity to detect and monitor CCA. In particular, the combination of these tumour markers seems to increase their efficiency in diagnosing of cholangiocarcinoma. New markers such as Soluble fragment of cytokeratin 19 (CYFRA 21-1) Mucins, Tumour Markers2- pyruvate-Kinase (TuM2- PK) and metalloproteinase-7 (MMP-7) have been recently shown to help in the diagnosis of CCA, with in some cases a prognostic value.

Abstract 1267: Characterization of carcinoembryonic antigen (CEA) microheterogeneity: a case study considering N-linked glycoforms

Abstract Colorectal cancer (CRC) is the second leading cause of cancer related deaths in the United States. A critical component of CRC care is post-surgical monitoring for cancer recurrence. Carcinogenicembryonic antigen (CEA) is a tumor marker for the clinical management of CRC which has the specific utility of monitoring post-operative disease recurrence. After surgery to remove cancerous tissue, the level of CEA in blood can be periodically monitored using an immunoassay. If the levels begin to rise above 6.0 ng/mL there is a high correlation with recurrence of the cancer. CEA, like many tumor markers is a glycoprotein and there is a significant body of work showing protein glycosylation is greatly affected by diseases such as cancer. We are investigating the CEA protein microheterogeneity in effort to improve its performance as a CRC biomarker. This poster presentation outlines our methods for glycoprotein characterization and includes qualitative and quantitative CEA glycoform data. CEA immuno-purified from cancerous liver was purchased from AbCam and processed without further purification. The purified protein was processed by SDS-PAGE on a 4-12% Bis-Tris NuPage gel (Invitrogen) in the MOPS buffer system. A second instance of the purified protein was deglycosylated with PNGaseF (New England Biolabs) and processed using the same SDS-PAGE conditions. The windows corresponding to the modified and unmodified proteins were excised and processed by in-gel digestion using a robot (ProGest, DigiLab) and Promega sequencing grade trypsin. The digested sample was analyzed by nano LC/MS/MS with a Waters NanoAcquity HPLC system interfaced to a ThermoFisher Orbitrap Velos Pro. Peptides were loaded on a trapping column and eluted over a 75µm analytical column at 350nL/min; both columns were packed with Jupiter Proteo resin (Phenomenex). The mass spectrometer was operated in data-dependent mode, with MS performed in the Orbitrap at 60,000 FWHM resolution and MS/MS performed in the dual linear ion traps. The fifteen most abundant ions were selected for MS/MS. Data were processed using bioinformatics tools and manually to identify and validate N-glycosylation sites and associated N-linked glycans. Glycoform quantitation was performed using High Resolution Accurate Mass (HRAM) and when necessary glycosites were confirmed using MS3 analysis. This presentation summarizes a workflow for the identification and quantification of protein glycoforms and shows the combination of immuno-purification, a targeted multiple enzyme approach and high resolution accurate mass data enables the accurate identification of N-glycosites and their glycoforms. The data from these experiments highlight the complexity of CEA glycoforms, for example a single N-linked glycosite on the peptide LQLSNGNR has over 30 associated glycoforms of varying abundance. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1267. doi:1538-7445.AM2012-1267

Efficacy of Carcinogenic Embryonic Antigen in Differential Diagnosis of Diseases of Pancreas and Liver - A Comparative Study in a Tertiary Care Hospital of Western Nepal

The objective of our present study was to assess the efficacy of carcinoembryonic antigen (CEA) for differentiating and diagnosis of pancreatic and liver diseases in Pokhara valley. A hospital based retrospective study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January, 2011 and 31st October, 2011. Estimation of CEA was performed by ELISA reader for all cases. Approval for the study was obtained from the institutional research ethical committee. Of the 771 subjects, 208 (27%), 60(7.8%), 240(31.1%), 54(7.0%) , 75(9.7%), 59(7.7%), 75(9.7%) cases were of active chronic hepatitis , cryptogenic cirrhosis, alcoholic cirrhosis, primary biliary cirrhosis, hepatoma, acute or chronic pancreatitis, carcinoma of pancreas respectively. The majority of cases (104) of active chronic hepatitis had CEA levels <5 ng/ml(50%). CEA levels were found to be increased in cases of alcoholic cirrhosis with maximum number of cases (106) in range of 10 to 20 ng/ml (44%). There were no cases having more than 20 ng/ml of CEA in primary biliary cirrhosis and acute or chronic pancreatitis. In cases of pancreatic cancer, maximum number of cases (35) were having CEA >20 ng/ml(47%). High levels of CEA are associated with advanced stage of disease. CEA can thus provide an important improvement in the diagnosis by differentiating pancreatic cancer especially from chronic pancreatitis when there is a high suspicion of malignancy. Increased CEA levels may also signify progression from benign to malignant transformation in the liver.

Sravnitel'naya kliniko-diagnosticheskaya znachimost' nekotorykh serologicheskikh opukholeassotsiirovannykh markerov dlya razlichnykh gistologicheskikh tipov raka legkogo

The authors selected a combination of serological tumor-associated markers for each histological type of tumors to enhance the sensitivity of clarifying laboratory diagnosis and monitoring of patients with lung cancer (LC). The serum levels of carcinogenic embryonic antigen (CEA), SCC, Cyfra 21-1, and ProGRP were studied in 57 primary patients with Stages I-IV LC of various histological types (squamous-cell and small-cell carcinoma, adenocarcinoma), in 12 patients with noncancer lung diseases, and in 13 healthy individuals. The highest sensitivity was demonstrated by the combined determination of Cyfra 21-1 and SCC for squamous-cell LC (88.2%) and that of CEA and Cyfra 21-1 for lung adenocarcinoma (57.1%). On a small sample of patients, the new serological marker ProGRP showed not only a high sensitivity (75%) for small-cell LC, but also a high specificity (94.3%) for non-small-cell LC. These results agree with few data in the foreign literature and suggest that the marker should be used for the specifying differential diagnosis of small-cell LC and the monitoring of patients with type of LC.

Strict follow-up programme including CT and 18F-FDG-PET after curative surgery for colorectal cancer

The risk of local recurrence following curative surgery for colorectal cancer (CRC) is up to 50%. A rigorous follow-up program may increase survival. Guidelines on suitable methods for scheduled follow up examinations are needed. This study evaluates a strict follow-up program including carcinogenic embryonic antigen (CEA), chest X-ray, abdominal ultrasound (US), computed tomography (CT) and (18)F-FDG positron emission tomography (FDG-PET). A cohort of 132 patients, treated by surgery with curative intent for CRC, was included. Patients were followed prospectively with scheduled controls at 3, 6, 12 and 24 months after curative surgery. CEA, chest X-ray, US, CT and FDG-PET supplemented by clinical examination. The end-point was recurrence. Sensitivity and specificity was estimated 2 years after surgery. Of the 132 patients included in the study, 25 experienced recurrence, detected at scheduled controls (n = 18) and at intervals between them (n = 7). The results of CT and FDG-PET were correlated with recurrence. CT combined with FDG-PET had the highest specificity and sensitivity. A total of 72% of recurrences were detected at scheduled controls. The findings supported a strict follow-up program following curative surgery for colorectal cancer. FDG-PET combined with CT should be included in control programs.