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Carcinoembryonic antigen

carcinoembryonic antigen, carcinoembryonic antigen levels
Carcinoembryonic antigen CEA describes a set of highly related glycoproteins involved in cell adhesion CEA is normally produced in gastrointestinal tissue during fetal development, but the production stops before birth Therefore, CEA is usually present only at very low levels in the blood of healthy adults However, the serum levels are raised in some types of cancer, which means that it can be used as a tumor marker in clinical tests Serum levels can also be elevated in heavy smokers2

CEA are glycosyl phosphatidyl inositol GPI cell-surface-anchored glycoproteins whose specialized sialofucosylated glycoforms serve as functional colon carcinoma L-selectin and E-selectin ligands, which may be critical to the metastatic dissemination of colon carcinoma cells345 Immunologically they are characterized as members of the CD66 cluster of differentiation The proteins include CD66a, CD66b, CD66c, CD66d, CD66e, CD66f

Contents

  • 1 History
  • 2 Diagnostic significance
  • 3 Genetics
  • 4 See also
  • 5 References
  • 6 External links

Historyedit

CEA was first identified in 1965 by Phil Gold and Samuel O Freedman in human colon cancer tissue extracts6

Diagnostic significanceedit

The CEA blood test is not reliable for diagnosing cancer or as a screening test for early detection of cancer7 Most types of cancer do not result in a high CEA levelcitation needed

Serum from individuals with colorectal carcinoma often has higher levels of CEA than healthy individuals above approximately 25 µg/L8 CEA measurement is mainly used as a tumor marker to monitor colorectal carcinoma treatment, to identify recurrences after surgical resection, for staging or to localize cancer spread through measurement of biological fluids9 CEA levels may also be raised in gastric carcinoma, pancreatic carcinoma, lung carcinoma, breast carcinoma, and medullary thyroid carcinoma, as well as some non-neoplastic conditions like ulcerative colitis, pancreatitis, cirrhosis,10 COPD, Crohn's disease, hypothyroidism 11 as well as in smokerscitation needed Elevated CEA levels should return to normal after successful surgical removal of the tumor of what for whatclarifycitation needed

CEA elevation is known to be affected by multiple factors It varies inversely with tumor grade; well-differentiated tumors secrete more CEA CEA is elevated more in tumors with lymph node and distant metastasis than in organ-confined tumors and, thus, varies directly with tumor stage Left-sided tumors generally tend to have higher CEA levels than right-sided tumors Tumors causing bowel obstruction produce higher CEA levels Aneuploid tumors produce more CEA than diploid tumors Liver dysfunction increases CEA levels as the liver is the primary site of CEA metabolism12

Regions of high CEA levels in the body can be detected with the monoclonal antibody arcitumomabclarification needed

Antibodies to CEA are also commonly used in immunohistochemistry to identify cells expressing the glycoprotein in tissue samples In adults, CEA is primarily expressed in cells of tumors some malignant, some benigncitation needed but they are particularly associated with the adenocarcinomas, such as those arising in the colon, lung, breast, stomach, or pancreas It can therefore be used to distinguish between these and other similar cancers For example, it can help to distinguish between adenocarcinoma of the lung and mesothelioma, a different type of lung cancer which is not normally CEA positive Because even monoclonal antibodies to CEA tend to have some degree of cross-reactivity, occasionally giving false positive results, it is commonly employed in combination with other immunohistochemistry tests, such as those for BerEp4, WT1, and calretinin13

Geneticsedit

CEA and related genes make up the CEA family belonging to the immunoglobulin superfamily

In humans, the carcinoembryonic antigen family consists of 29 genes, 18 of which are normally expressed14 The following is a list of human genes which encode carcinoembryonic antigen-related cell adhesion proteins: CEACAM1, CEACAM3, CEACAM4, CEACAM5, CEACAM6, CEACAM7, CEACAM8, CEACAM16, CEACAM18, CEACAM19, CEACAM20, CEACAM21

See alsoedit

  • List of histologic stains that aid in diagnosis of cutaneous conditions

Referencesedit

  1. ^ Boehm, M K; Perkins, S J 2000 "Structural models for carcinoembryonic antigen and its complex with the single-chain Fv antibody molecule MFE23" FEBS Letters 475 1: 11–16 PMID 10854848 doi:101016/S0014-57930001612-4 
  2. ^ Duffy, Michael J 2001-04-01 "Carcinoembryonic Antigen as a Marker for Colorectal Cancer: Is It Clinically Useful" Clinical Chemistry 47 4: 624–630 ISSN 0009-9147 PMID 11274010 
  3. ^ Thomas SN, Zhu F, Schnaar RL, Alves CS, Konstantopoulos K Jun 2008 "Carcinoembryonic antigen and CD44 variant isoforms cooperate to mediate colon carcinoma cell adhesion to E- and L-selectin in shear flow" J Biol Chem 283 23: 15647–55 PMC 2414264  PMID 18375392 doi:101074/jbcM800543200 
  4. ^ Konstantopoulos K, Thomas SN 2009 "Cancer cells in transit: the vascular interactions of tumor cells" Annu Rev Biomed Eng 11: 177–202 PMID 19413512 doi:101146/annurev-bioeng-061008-124949 
  5. ^ Thomas SN, Tong Z, Stebe KJ, Konstantopoulos K 2009 "Identification, characterization and utilization of tumor cell selectin ligands in the design of colon cancer diagnostics" Biorheology 46 3: 207–25 PMID 19581728 doi:103233/BIR-2009-0534 
  6. ^ Gold P, Freedman SO March 1965 "DEMONSTRATION OF TUMOR-SPECIFIC ANTIGENS IN HUMAN COLONIC CARCINOMATA BY IMMUNOLOGICAL TOLERANCE AND ABSORPTION TECHNIQUES" The Journal of Experimental Medicine 121: 439–62 PMC 2137957  PMID 14270243 doi:101084/jem1213439 
  7. ^ Duffy, M J; Van Dalen, A; Haglund, C; Hansson, L; Klapdor, R; Lamerz, R; Nilsson, O; Sturgeon, C; Topolcan, O 2003 "Clinical utility of biochemical markers in colorectal cancer: European Group on Tumour Markers EGTM guidelines" European journal of cancer Oxford, England : 1990 39 6: 718–727 PMID 12651195 doi:101016/S0959-80490200811-0 
  8. ^ Ballesta, AM; Molina, R; Filella, X; Jo, J; Giménez, N 1995 "Carcinoembryonic antigen in staging and follow-up of patients with solid tumors" Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine 16 1: 32–41 PMID 7863220 doi:101159/000217926 
  9. ^ Duffy, Michael J April 2001 "Carcinoembryonic Antigen as a Marker for Colorectal Cancer: Is It Clinically Useful" Clinical Chemistry 47 4: 624–630 
  10. ^ Maestranzi, S; Przemioslo, R; Mitchell, H; Sherwood, RA Jan 1998 "The effect of benign and malignant liver disease on the tumour markers CA19-9 and CEA" Ann Clin Biochem 35 1: 99–103 PMID 9463746 doi:101177/000456329803500113 
  11. ^ De Mais, Daniel ASCP Quick Compendium of Clinical Pathology, 2nd Ed ASCP Press 2009
  12. ^ Duffy, Michael J 2001-04-01 "Carcinoembryonic Antigen as a Marker for Colorectal Cancer: Is It Clinically Useful" Clinical Chemistry 47 4: 624–630 ISSN 0009-9147 PMID 11274010 
  13. ^ Leong, Anthony S-Y; Cooper, Kumarason; Leong, F Joel W-M 2003 Manual of Diagnostic Cytology 2 ed Greenwich Medical Media, Ltd pp 51–52 ISBN 1-84110-100-1 
  14. ^ Hammarström S April 1999 "The carcinoembryonic antigen CEA family: structures, suggested functions and expression in normal and malignant tissues1" Seminars in Cancer Biology 9 2: 67–81 PMID 10202129 doi:101006/scbi19980119 

External linksedit

  • Carcinoembryonic Antigen at the US National Library of Medicine Medical Subject Headings MeSH
  • CEA at Lab Tests Online
  • CEA: analyte monograph from The Association for Clinical Biochemistry and Laboratory Medicine

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