carcinoembryonic antigen

Discussion in 'MRCS Forum' started by Javed., Jan 31, 2008.

  1. Javed.

    Javed. Guest

    Q. You are trying to facilitate use of screening for a variety of cancers in your cancer center. The use of carcinoembryonic antigen (CEA) has increased dramatically; however, there have been no studies of its effectiveness, nor has it been suggested that there be a policy on the use of this assay. Which of the following statements is true regarding CEA?
    a- CEA is an accurate screening test for primary colorectal cancer
    b- CEA levels have not been helpful in the diagnosis of recurrent colorectal cancer
    c- CEA levels, when elevated, are highly specific for colon cancer
    d- CEA is present in normal colonic mucosa
    e- Postoperative CEA assay is 70% accurate in predicting the appearance of liver metastases within 1 year
  2. Javed.

    Javed. Guest

    Answer: e. (Greenfield, 2/e, p 1138) CEA is a glycoprotein that is present in early embryonic and fetal cells (an oncofetal antigen) and in colon cancer. It is not found in normal colon mucosa. It is not tumor-specific and may be elevated in a variety of benign and malignant conditions, including cirrhosis, ulcerative colitis, renal failure, pancreatitis, pancreatic cancer, stomach cancer, breast cancer, and lung cancer. However, the CEA assay is a sensitive serologic tool for identifying recurrent disease. In about two-thirds of patients with recurrent disease, an increased CEA level is the first indicator of tumor reappearance. A rising CEA following colon cancer surgery, in the absence of other conditions associated with an elevated CEA, predicts the appearance of liver metastases within 1 year with an accuracy approaching 70%.

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