The level of tumor-associated antigen (TA-4) was determined in the serum and tumor tissue of patients with squamous cell carcinoma of the cervix by radioimmunoassay and immunoperoxidase techniques. Using an arbitrary limit of 2.5 ng/ml of serum, positive values were observed in 5.5% of healthy controls and 53.6% of patients with cervical squamous carcinoma. The mean value and incidence of elevation of serum TA-4 increased significantly with advancing disease stage. There was, however, no significant increase in serum TA-4 in the early stages of disease. Elevated TA-4 in serum rapidly fell to normal within 72 hours after radical surgery, but remained elevated if complete excision could not be performed. In case of radiotherapy, TA-4 levels in serum and tumor tissue often increased during the administration of the initial 2000 rad, and subsequently declined after the administration of a total of more than 4000 rad. The decline of serum TA-4 to normal observed during radiotherapy was found to be closely correlated with the disappearance of viable cancer cells in histopathologic specimens from the cervix. Immunohistochemical TA-4 staining was present in large cell nonkeratinizing carcinoma, but not in small cell nonkeratinizing carcinoma. These results indicate that the expression of TA-4 antigen in cervical squamous carcinoma is related to differentiation of the tumor cells and that serum TA-4 determination, despite its limitation for early diagnosis, provides a potential means for monitoring the effects of individual therapy for cervical squamous cell carcinoma.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/1097-0142%2819850715%2956%3A2%3C302%3A%3AAID-CNCR2820560217%3E3.0.CO%3B2-T

Tumor-associated antigen, TA-4, in the monitoring of the effects of therapy for squamous cell carcinoma of the uterine cervix. Serial determinations and tissue localization.

A quantitative study of carcinoembryonic antigenic activity (CEA) in extracts of 44 tumors, 42 fetal and 36 non-malignant adult tissues from various organs was made and the CEA content detected by microradioimmunoassay was related to the wet tissue weight. A variety of malignant neoplasms, including carcinomas, sarcoma and Hodgkin's disease, contained CEA (range 17 to 2727 ng); apart from gastrointestinal carcinomas which had the highest content of CEA (230–2727 ng/g) only carcinomas of the lung contained moderate amounts of CEA (63–950 ng/g). The amount of CEA in extracts of fetal and normal adult organs was mostly low or not detectable except in the gastrointestinal tract and pancreas where it ranged from 65 to 200 ng/g in the fetus, and 28 to 86 ng/g in the adult. Differences in mean content of CEA between normal and cirrhotic livers were not significant. Although our results indicated that CEA was present in varying amounts in a variety of tumors the identification of these reactive substances will require more precise physico-chemical and antigenic characterization.

Carcinoembryonic antigenic activity of tissue extracts: a quantitative study of malignant and benign neoplasms, cirrhotic liver, normal adult and fetal organs.

To further define and determine the usefulness of CEA, 1100 CEA determinations have been made over the past two years at The Ohio State University Hospitals on patients with a variety of malignant and nonmalignant conditions Correlation of CEA titers with history and clinical course has yielded interesting results not only in cancers of entodermally derived tissues, for which CEA has become an established adjunct in management, but also in certain other neoplasms and inflammatory states The current total of 225 preoperative CEA determinations in colorectal carcinomas shows an 81% incidence of elevation, with postoperative titers remaining elevated in patients having only palliative surgery but falling to the negative zone after curative procedures An excellent correlation exists between CEA levels and grade of tumor (more poorly differentiated tumors showing lower titers) Left-side colon lesions show significantly higher titers than right-side lesions CEA values have been shown to be elevated in 90% of pancreatic carcinomas studied, in 60% of metastatic breast cancers, and in 35% of other tumors (ovary, head and neck, bladder, kidney, and prostate cancers) CEA levels in 35 ulcerative colitis patients show elevation during exacerbations (51%) During remissions titers fall toward normal, although in 31% still remaining greater than 25 ng/ml In the six colectomies performed, CEA levels all fell into the negative zone postoperatively Forty percent of adenomatous polyps showed elevated CEA titers (range 25-100) that dropped following polypectomy to the negative zone Preoperative and postoperative CEA determinations are important in assessing the effectiveness of surgery Serial CEA determinations are important in the follow-up period and in evaluation of the other modes of therapy (eg, chemotherapy) These determinations of tumor antigenicity give the physician added prognostic insight into the behavior of the tumor growth Rectal examination with guaiac determinations, sigmoidoscopy, cytology, barium enema, and a good clinical evaluation remain the primary tools for detecting colorectal disease However, in the high-risk patient suspicious of developing cancer, CEA determinations as well as colonoscopy are now being used increasingly and provide additional highly valuable tools in the physician's armamentarium

Carcinoembryonic antigen: clinical and historical aspects.

For many years medical scientists have been able of producing a variety of "inappropriate" seeking an ideal and reliable "cancer test". Many factors such as the "ectopic" hormones and oncohave been proposed; none has stood the test of fetal antigens (for reviews, see Laurence and dctailed:and critical evaluation. With the demonstraNeville, 1972; Rees and Ratcliffe, 1974) there has tion)hat many, if not all, human tumours are capbeen a renewed interest in biochemical approaches

https://journals.sagepub.com/doi/pdf/10.1177/000456327601300101

Biochemical monitoring of cancer. A review.

Carcinoembryonic antigen (CEA): molecular biology and clinical significance.

Summary: Carcinoembryonic antigen (CEA) in serum was studied serially in 27 patients with cancer of the female reproductive system and 7 patients with other cancers, particularly of the colon or rectum, after surgical excision, irradiation, or no treatment. CEA became undetectable 2 weeks after complete surgical excision of cancer, whereas persistence of elevated levels of CEA indicated residual cancer. However, there was no decline in levels of CEA after radical radiotherapy of cervical carcinoma over a 10‐week period of study, suggesting continuous release of CEA from tumour tissues undergoing radiation‐induced necrosis. Sequential levels of CEA in serum represent a good index of effectiveness of surgical excision of cancer and should thus be of great value in post‐operative follow‐up. Copyright

Carcinoembryonic Antigen in Cancer of the Female Reproductive System Sequential Levels and Effects of Treatment

Summary: Carcinoembryonic antigen (CEA) is demonstrable in whole serum of patients with cancers of the female reproductive system. Positive results, taken arbitrarily as levels of CEA exceeding 5 ng./ml., were obtained in 60% of such patients; the highest incidence of positive results was present in patients with ovarian and breast cancer (73% and 70%). By comparison, none of 73 patients with benign gynaecological conditions such as cervicitis and dysfunctional uterine bleeding, and only 4% of unselected blood donors, had a positive result. The incidence of high levels of CEA (values of 10 ng./ml. or more) was lower in patients with cancer of the reproductive system (56 of 171) than in those with cancer of the digestive system (96 of 138). There was no difference in incidence of positive results for patients with adenocarcinoma and with squamous cell carcinoma of the female genital organs. In general, a higher incidence of positive results and higher levels of CEA were present in patients with extensive or meta-static disease, but positive results were found even in those with pre-invasive lesions (carcinoma in situ and severe dysplasia).

S. K. Khoo

Papers

Carcinoembryonic Antigen in Cancer of the Female Reproductive System Sequential Levels and Effects of Treatment

Carcinoembryonic antigen in cancer of the female reproductive system: its detection in serum by a microradioimmunoassay.