Demonstration Of Carcinoembryonic Antigen Research Articles

Immunohistochemically Detectable Duct‐like Structures in Benign and Malignant Eccrine Poromas: CEA and Involucrin Immunostaining

The duct-like structures present in 7 cases of benign and malignant eccrine poroma were examined by immunohistochemical staining for carcinoembryonic antigen (CEA), involucrin, and S-100 protein. The demonstration of CEA and involucrin was helpful in the recognition of these structures. The overt immunopositivity precedes morphological evidence for duct formation. On the basis of the CEA immunostaining, the duct-like structures were divided into 4 types: 1) mature acrosyringeal structure, 2) cystic luminal structure lined by elongated cells, 3) immature acrosyringeal structure, and 4) vacuole- or dot-like potential lumen in a single cell. Involucrine was observed in the lining cells of 1) and 2). None of the 4 types showed positive reactivity for S-100 protein, suggesting the irrelevance of these structures to the secretory element of sweat gland. The polymorphism of the ductal formation tended to be more remarkably observed in malignant eccrine poromas than in the cases of benign eccrine poroma and poroepithelioma tested.

Demonstration of carcinoembryonic antigen (CEA) expression in normal, chronically inflamed, and malignant pancreatic tissue by immunohistochemistry.

The expression of carcinoembryonic antigen (CEA) was evaluated by immunoperoxidase staining with two anti-CEA monoclonal antibodies in normal, chronically inflamed, and malignant pancreatic tissue. Positive staining was not observed in normal specimens. In pancreatic cancer the expression of CEA was related to the degree of differentiation of the tumour. Positive staining was also observed in chronic pancreatitis.

CEA and NCA in benign and malignant breast tumors.

The involvement of Nonspecific Crossreacting Antigen (NCA) in the immunohistological demonstration of Carcino Embryonic Antigen (CEA) in 56 benign and 92 malignant lesions of the breast was analyzed. For this purpose, the authors utilized both polyclonal antisera and monoclonal antibodies. Polyclonal anti-CEA sera were used after absorption with normal tissue antigens, in order to remove crossreactivity, and without such an absorption. Ninety-three percent of breast carcinomas, 85% of mastopathic lesions not associated with a carcinoma, and 66% of fibroadenomas showed positive reactions with commercial unabsorbed polyclonal anti-CEA serum, which contained antibodies to NCA, whereas incubation with monospecific anti-CEA antiserum resulted in 42% positivity in carcinomas and negativity in mastopathic lesions and fibroadenomas. Forty-eight percent of breast cancer, 84% of mastopathic lesions, and 50% of the fibroadenomas contained NCA in different quantities. The staining pattern of carcinomas and fibroadenomas obtained with unabsorbed anti-CEA antibody and anti-NCA did not run parallel in all cases. Monoclonal antibodies against CEA and NCA confirmed the results obtained with polyclonal antiserum. This study suggests a cancer specificity of CEA in breast lesions.

Demonstration of carcinoembryonic antigen in bone marrow from patients with carcinoma.

Primary and secondary tumour and bone marrow trephine biopsies from 20 patients with carcinomas were stained for carcinoembryonic antigen by the three stage immunoperoxidase method. Six marrow biopsies contained tumour deposits, five of which were positive for carcinoembryonic antigen. A further five marrow biopsies contained single carcinoembryonic antigen positive cells of uncertain origin. Carcinoembryonic antigen staining may be a useful adjunct to conventional histology in the diagnosis of marrow metastases.

Cross-reactivity with normal antigens in commercial anti-CEA sera, used for immunohistology. The need for tissue controls and absorptions.

The demonstration of carcinoembryonic antigen (CEA) in serum and in tissue sections may be of value in diagnosis and follow-up of several malignant tumors. Anti-CEA sera, however, cross-react with normal antigens, also present in tumors. The staining patterns of three commercially produced anti-CEA sera were investigated on sections of benign and malignant tissues, using an indirect immunoperoxidase technic. All three anti-CEA sera tested showed cross-reactions. A rapid, simple, and reproducible immunoabsorption was developed. After absorption, the reactivity of the sera with normal colon mucosa and carcinomas of the colon remained positive, whereas sections of benign tissues were negative. Moreover, four of ten breast cancers, positive with unabsorbed antisera, became negative after absorption. These findings stress the importance of immunohistochemical negative and positive controls. The use of well-absorbed commercial anti-CEA sera can lead to more uniform results, exchangeability of results, and a better understanding of the value of this tumor marker.

Demonstration of carcinoembryonic antigen (CEA) by means of the immunoperoxidase technique in paraffin-embedded specimens of tumour tissues

The unlabelled antibody-enzyme method with the peroxidase-antiperoxidase complex (PAP-complex) was used to demonstrate carcinoembryonic antigen (CEA) or CEA-like substances in paraffin-embedded specimens of tumour tissues with an anti-CEA-antiserum of a rabbit. The anti-CEA-antiserum used in this study exhibited a high anti-CEA-activity and a low activity to an impurity. The paraffin-embedded specimens of tumour tissues were investigated at serum dilutions of 1 : 16, 1 : 64, and 1 : 256. The sections of colorectal cancer showed the highest content of CEA. In 36 of 37 cases the tumour tissue reacted to the anti-CEA-antiserum up to a dilution of 1 : 256. The stomach cancer tissues contained significantly lower CEA-levels than the colorectal cancer. The sarcomas, malignant melanomas, the tumour of testis, the prostatic cancers and basal cell carcinomas of the skin were found to contain none or very low CEA-content. In most specimens of these tumours the CEA was not demonstrable at a 1 : 16 dilution of the primary antiserum.

Demonstration of carcinoembryonic antigen in human breast carcinomas by the immunoperoxidase technique.

Using an antiserum against carcinoembryonic antigen, which was free from non-specific cross-reacting antigen activity, carcinoembryonic antigen has been demonstrated in 45 out of 90 breast carcinomas by an indirect three-stage immunoperoxidase method. The presence of carcinoembryonic antigen appears to be related to good histological differentiation but not to histological type, lymph node metastasis, or recurrence within two years of primary diagnosis. It is suggested that the varying results obtained by different workers may be due to the differing characteristics of the anti-carcinoembryonic antigen serum used.

DISTINCTION BETWEEN ENDOCERVICAL AND ENDOMETRIAL ADENOCARCINOMA WITH IMMUNOPEROXIDASE STAINING OF CARCINOEMBRYONIC ANTIGEN IN ROUTINE HISTOLOGICAL TISSUE SPECIMENS

The differential diagnosis of endocervical and endometrial adenocarcinomas can be improved by the demonstration of carcinoembryonic antigen (CEA) in tissue by means of immunoperoxidase staining. Tissue from 131 (80%) of 163 patients with endocervical adenocarcinoma but only 11 (8%) of 137 patients with endometrial adenocarcinoma was CEA-positive. The commonest exceptions were endocervical mesonephroid adenocarcinomas (which were CEA-negative) and endometrial adenosquamous carcinomas (which were CEA-positive). After exclusion of these on simple morphological criteria, 86 of 107 endocervical adenocarcinomas (80%) were CEA-positive, and all 122 endometrial adenocarcinomas were CEA-negative. The remarkable difference in the expression of CEA between endocervical and endometrial adenocarcinomas suggests a novel application of immunohistochemistry in routine clinical practice.

Correlation of carcinoembryonic antigen in tissue sections with spread of mammary carcinoma

An immunoperoxidase technique for the histological demonstration of Carcinoembryonic Antigen (CEA) was applied to paraffin sections from 74 breast carcinomas and 43 benign breast lesions. Sixty-six per cent of the carcinomas and the only case of granular cell myoblastoma examined were CEA positive. Two examples of mammary dysplasia (7%) showed foci of CEA positive acini. All tumour tissue found in lymphatics and in metastases in lymph nodes was CEA positive, including two cases where the primary tumour was CEA negative, and all the metastases examined from CEA positive tumours. A significant relationship was found between CEA positivity of the primary tumour and the presence of lymph node metastases.

The demonstration of carcinoembryonic antigen in colorectal carcinoma and colonic polyps using an immunoperoxidase technique.

Carcinoembryonic antigen (CEA) has been demonstrated in tissues, by immunofluorescence, with conflicting results. Originally thought to be persent in colorectal carcinoma only, the antigen was later demonstrated in inflamed colonic mucosa and polyps. Using formalin-fixed, paraffin-embedded tissues and an immunoperoxidase technique, we have attempted to demonstrate CEA in 12 colorectal carcinomas, in adjacent benign mucosa, and in 42 polyps of varying histologic type. CEA was demonstrated in all colorectal cancers but not in adjacent inflamed mucosa. The antigen could not be demonstrated in polyps except in five cases where CEA was shown in morphologically atypical glands only. With out technique, the demonstration of CEA is a reliable indicator of malignant change in colonic mucosa. The findings in polyps tend to support the concept of carcinoma in situ in adenomatous polyps and the polyp-cancer sequence.

Demonstration of carcinoembryonic antigen in normal human plasma.

CARCINOEMBRYONIC antigen (CEA) was first reported by Gold and Freedman as a tumour-specific antigen found in tissue extract of adenocarcinoma of human colon and not present in normal colonic tissue1,2; also, CEA has been detected in the plasma of patients with other malignant diseases3–6, and small quantities have also been found in normal colon and lung7–8. We report the results of our studies on the demonstration of CEA in plasma of normal healthy individuals by radioimmunoassay and column chromatography.