Clinical importance of preoperative carcinoembryonic antigen and carbohydrate antigen 19-9 levels in gastric cancer

Although serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 are commonly measured before surgery for gastric carcinoma, this clinical significance is not fully understood. We evaluated a total of 549 patients with gastric cancer who underwent gastrectomy. Levels of CEA and CA19-9 were measured preoperatively in all patients. We retrospectively analyzed correlations between CEA or CA19-9 and clinicopathologic features, and estimated the prognostic utility of the tumor markers by analyzing clinicopathologic characteristics of the carcinoma as a function of seropositivity or negativity of the antigens in combination or by raising the levels. The positivity rates of CEA (> or =5 ng/mL) and CA19-9 (> or =37 U/mL) were 19.5% and 18%, respectively. Serum CEA and CA19-9 positivity significantly correlated with depth of invasion, hepatic metastasis, and curativity. Forty-nine patients positive for both CEA and CA19-9 had significantly higher frequencies of lymph node metastasis, deeper invasion by the tumor, lower rates of curative resection (p < 0.01), and higher rates of hepatic metastasis (p < 0.05) than 377 patients with normal levels of CEA and CA19-9. Surgical outcomes of patients who were CEA- and CA19-9-positive were poorer than those of patients with normal CEA and CA19-9 levels (p < 0.01). Significant correlation was found between serum CEA and CA19-9 level (p < 0.001, r = 0.24). Doubling the threshold level of serum positivity to 10 ng/mL (CEA) and 74 U/mL (CA19-9) improved the prognostic value of these factors. However, multivariate analysis using Cox's hazards model revealed that only CEA positivity using the doubled threshold value (10 ng/mL) (p = 0.04, hazard ratio = 1.7), nodal involvement (p = 0.01, hazard ratio = 1.9), and depth of invasion (p = 0.02 hazard ratio = 1.5) significantly predicted prognosis. Carcinoembryonic antigen positivity using the doubled threshold level (10 ng/mL) was an important prognostic factor in patients with gastric cancer.     

Serological studies on CEA, CA 19-9, STn and SLX in colorectal cancer.

BACKGROUND/AIMS: Sialyl Le(x) (NeuAca2-3Galb1-4(Fuca1-3)GlcNAc1-R) (SLX) was introduced as cancer-associated. In this study, serological expression of SLX was examined with that of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9) and sialyl Tn antigen (STn) concerning the prognosis and clinicopathological findings of patients with colorectal carcinoma. METHODOLOGY: One hundred and seventeen patients were operated on for colorectal cancer and were enrolled in this study. Serum CEA, CA 19-9, STn and SLX levels were measured pre-operatively by radioimmunoassays and the cut-off values were 5ng/ml, 37U/ml, 45U/ml, and 38U/ml, respectively. RESULTS: Serologically, the positive rates of CEA, CA 19-9, STn and SLX antigens were 33.3, 26.5, 23.1, and 17.1%, respectively. The CEA, CA 19-9 and SLX are stage specific in clinical stage. In the CEA, CA 19-9, STn, SLX-positive patients, 5-year survival rates were 41.0, 29.7, 50.1, and 29.1%, respectively. In the tumor marker-positive patients, prognosis was significantly poorer than in the negative patients. In the patients with Curability A or B, the difference in survival between the SLX-positive and negative patients was significant. Multivariate analysis revealed that significant prognostic indicators were accompanying liver metastasis, histological type, depth of invasion, CEA and SLX. CONCLUSIONS: The combination assay of serum CEA, CA 19-9, STn and SLX will be beneficial for diagnosis and follow-up of colorectal cancer.     

Serum levels of the oncofetal antigens CA-125, CA 19-9 and CA 15-3 in patients with endometriosis

The levels of the oncofetal antigens CA-125, CA 19-9 and CA 15-3 were measured in serum samples taken from 8 women, aged 21 to 37 yr, before treatment, during the last fifteen days of a 6-month administration of danazol and finally three months after treatment withdrawal. The purpose of the study was to investigate: i) whether endometriosis belongs to the pathologic conditions which induce a concomitant increase in the values of CA-125, CA 19-9 and CA 15-3, and ii) the effect of danazol on the levels of these antigens. Our results indicate that before danazol treatment, three women showed pathologic levels of all three antigens, one of CA 19-9 and CA 15-3, one of CA 19-9 alone, and two of CA 15-3 alone. Administration of the drug significantly reduced the levels of CA-125 (p less than 0.001) and CA 19-9 (p less than 0.05) and to a lesser degree the levels of CA 15-3. Three months after danazol treatment discontinuation, the levels of these three antigens remained significantly lower (p less than 0.05) than the respective pretreatment values. Our findings substantiate the view that endometriosis must be classified with the pathologic conditions which induce a rise in the levels of all three antigens, and that ovarian function mainly influences the levels of CA-125 and CA 19-9.     

Clinical evaluation of serum sialyl SSEA-1 (SLX) in diagnosis of cancers

In order to evaluate the usefulness of sialyl SSEA-1 (SLX) as a tumor marker of digestive cancers, serum levels of the antigen were determined in 334 patients with malignancies and 196 patients with benign diseases. The results indicated that positivity of the antigen in sera from malignant patients was highest in pancreatic cancer (58%) and biliary tract cancer (56%). False positive incidence of SLX in sera from benign diseases was as low as 6%, revealing low false positivity. Comparison with other tumor markers such as CA19-9, CA-50, CEA and ST-439 showed that positivity of SLX was as high as that of CEA, whereas it was lower than that of CA19-9 or CA-50. On the other hand, false positivity of SLX as well as ST-439 was lowest, and accuracy of SLX was no less high than that of CA19-9 or CA-50. In sera of pancreatic and biliary tract cancer, positive incidences of CA19-9, CEA and ST-439 were 80%, 64% and 53%, respectively, and the diagnostic efficiency increased by combined assay of SLX with CA19-9 (88%), CEA (81%) and ST-439 (71%). SLX appears to be no less useful than the other recently developed carbohydrate antigens or CEA as serum tumor marker for pancreatico-biliary cancer.     

Glycoprotein tumour markers in head and neck neoplasms —a consecutive study on CA-50, CA 19-9, and CEA

Summary Serum levels of three glycoprotein tumour antigens (carcino-embryonic antigen, CEA; cancer-associated antigen 50, CA-50; gastrointestinal cancer-associated antigen, CA 19-9) were determined on 125 consecutive patients with tumours of the head and neck region. Elevated CEA values (> 5 units/ml) were found in 13/70 squamous cell carcinomas, 3/21 benign and 4/18 malignant salivary gland neoplasms. Elevated CA-50 values (> 17 units/ml) were found in 19/70 squamous cell carcinomas, 6/18 malignant and 1/21 benign salivary neoplasms. CA 19-9 displayed higher values (> 37 units/ml) in 9/68 squamous cell carcinomas, 4/18 malignant and none of 21 benign salivary gland tumours. Combination of CEA and CA-50 analyses increased the proportion of elevated values to 30/70 in squamous cell carcinomas and 10/18 in salivary gland malignancies. In squamous cell carcinomas no correlation between staging or grading and serum levels was detected for any of the markers. Among malignant salivary gland tumours, CA-50 displayed enhanced serum values in 4/6 mucoepidermoid carcinomas. The mean values for CA-50 and CA 19-9 serum levels were significantly higher for malignant salivary gland neoplasms compared to benign tumours. There was a close correlation between CA-50 and CA 19-9 serum levels. Although, the results suggest that at present none of the tumour markers tested have a place alone in the routine examination of patients with tumours affecting the head and neck region, further studies on salivary gland neoplasms and combinations of the tumour markers are justified.This study was supported by grants from the Swedish Society for Cancer Research and Lions Research Foundation, Umeå Sweden     

Tissue expression of the cancer-associated antigens CA 19-9 and CA-50 in chronic pancreatitis and pancreatic carcinoma

The expression of the gastrointestinal cancer-associated antigens CA 19-9 and CA-50 was studied in 43 ductal pancreatic carcinomas, 1 mucinous cystadenoma, 1 signet-ring-cell carcinoma, 42 pancreata with chronic pancreatitis, and 10 normal fetal and adult pancreata. The anti-CA-50 antibody gave a more intense and more uniformly distributed staining of the ductal epithelial cells than the anti-CA 19-9 antibody. Both antigens, however, exhibited the same staining pattern of ductal epithelial cells in normal pancreas and chronic pancreatitis. Well differentiated carcinomas showed a predominantly membrane-bound antigen expression, whereas moderately and poorly differentiated carcinomas gave a more diffuse cytoplasmic staining. Epithelial dysplasia could not be differentiated by the staining pattern from normal, hyperplastic, metaplastic, or neoplastic cells. The immunohistochemical reaction with these anticarbohydrate antibodies, therefore, does not allow a qualitative discrimination between chronic pancreatitis and pancreatic carcinoma. CA 19-9, which expression depends on the Lewis gene, was negative in two patients with Le(a-b-) phenotype. Although anti-CA-50 antibody was reactive with the cancer cells of these 2 patients, the staining was weak and heterogenous.     

Comparative effectiveness of the tumour diagnostics, CA 19-9, CA 125 and carcinoembryonic antigen in patients with diseases of the digestive system.

Serum concentrations of CA 19-9, CA 125 and carcinoembryonic antigen (CEA) in 145 patients with gastrointestinal carcinomas and 89 with non-neoplastic diseases were determined to compare the clinical usefulness of these tumour markers. Significantly fewer positive cases were obtained with serum CA 19-9 (9%) and CA 125 (8%) tests than the CEA test (22%) (both p less than 0.05) in patients with benign diseases, while comparable sensitivities were achieved with the CA 19-9 (44%) test, the CA 125 (41%) test and the CEA test (47%) in those with a carcinoma. High incidences of raised concentrations of serum CA 19-9 and CA 125 were observed in case of cancer of the pancreas (CA 19-9: 87%, CA 125: 67%) and biliary tract (CA 19-9: 63%, CA 125: 48%). Combined tests of CA 19-9 and CA 125 revealed increments in the sensitivity (61%) and provided a higher specificity (87%) than that of the single CEA test (78%). These combined tests were most useful for a differential diagnosis of pancreatic carcinoma (97% positive) and biliary tract carcinoma (74%) from chronic pancreatitis (4%) and cholelithiasis (0%), respectively. Studies on the relations of clinical staging and serum concentrations of CA 19-9 and CA 125 revealed significant rises in cases of disseminated carcinoma. These results clearly show that serum CA 19-9 and CA 125 tests are most pertinent for diagnosing advanced carcinomas of organs in the digestive system.     

The use of tumor markers as predictors of prognosis in gastric cancer

BACKGROUND/AIMS: The aim of this study was to evaluate the prognostic significance of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9) levels in patients with gastric cancer. METHODOLOGY: During the period January 2000 and January 2003, 36 patients operated for primary gastric cancer, at Sisli Etfal Training and Research Hospital, Department of General Surgery, were analyzed. Serum CEA and CA19-9 levels were determined preoperatively and the correlation between the elevated levels of tumor markers and several clinicopathological features, and survival were evaluated. RESULTS: Elevated serum CEA and CA19-9 levels were determined in 10 of 35 patients (28.6%), and 9 of 31 patients (29%), respectively, and both markers were elevated in 3 of 31 patients (9.6%). Elevated levels of CEA correlated with depth of invasion (p=0.018) and pathological stage (p=0.029); elevated levels of CA19-9 correlated with lymph node metastasis (p=0.026); and elevated levels of both markers correlated well with lymph node metastasis (p=0.031). The survival of patients with normal CEA levels was significantly better than those with elevated levels (p=0.0072). CONCLUSIONS: Preoperative serum CEA and CA19-9 levels may add useful information in patients with gastric carcinoma, and CEA level is a predictor of prognosis.     

The Prognostic Value of Preoperative Serum Levels of CEA and CA19–9 in Patients with Gastric Cancer

Objectives : The clinical significance of preoperative serum levels of tumor markers CKA and CA19-9 was evaluated in gastric cancer patients. Methods: Serum levels of CEA and CA19-9 were measured in 663 patients with gastric cancer who underwent laparotomies over a recent 4-yr period (1990-1993). The correlations between the serum levels of tumor markers and several clinic opathological factors were evaluated by univariate analysis. The significance of the tumor markers as prognostic factors was assessed by multivariate analysis. Results : The positivity rates of CEA and CA19-9 were 16.6% and 16.0%, respectively. The positivity of CEA correlated well with the sex of the patients, hepatic, peritoneal, and nodal metastases and the depths of tumors, hut it correlated weakly with a tumor's histological type. The positivity of CA19-9 correlated well with various forms of metastases, depths, and tumor size. A significant difference in prognosis was observed between patients positive and negative for CA19-9 among those undergoing R0 resection. Multivariate analysis also revealed that serum CA19-9 level was better than CEA as a prognostic factor. Conclusions: CA19-9 in the preoperative sera is a good prognostic factor in gastric cancer patients, although tumor markers continue to have only limited diagnostic usefulness.     

Tissue expression of the cancer-associated antigens ca 19-9 and ca-50 in chronic pancreatitis and pancreatic carcinoma

The expression of the gastrointestinal cancer-associated antigens CA 19-9 and CA-50 was studied in 43 ductal pancreatic carcinomas, 1 mutinous cystadenoma, 1 signet-ring-cell carcinoma, 42 pancreata with chronic pancreatitis, and 10 normal fetal and adult pancreata. The anti-CA-50 antibody gave a more intense and more uniformly distributed staining of the ductal epithelial cells than the anti-CA 19-9 antibody. Both antigens, however, exhibited the same staining pattern of ductal epithelial cells in normal pancreas and chronic pancreatitis. Well differentiated carcinomas showed a predominantly membrane-bound antigen expression, whereas moderately and poorly differentiated carcinomas gave a more diffuse cytoplasmic staining. Epithelial dysplasia could not be differentiated by the staining pattern from normal, hyperplastic, metaplastic, or neoplastic cells. The immunohistochemical reaction with these anticarbohydrate antibodies, therefore, does not allow a qualitative discrimination between chronic pancreatitis and pancreatic carcinoma. CA 19-9, which expression depends on the Lewis gene, was negative in two patients with Le^a-b- phenotype. Although anti-CA-50 antibody was reactive with the cancer cells of these 2 patients, the staining was weak and heterogenous.     

Antigen detection by the monoclonal antibodies CA 19-9 and CA 125 in normal and tumor tissue and patients' sera

The tumor markers CA 19-9 and CA 125 defined by the monoclonal antibodies 19-9 and OC 125 were investigated with respect to organ specificity and tumor sensitivity. Normal and tumor tissue specimens, and blood samples from 34 patients with pancreatic carcinomas, 40 with ovarian carcinomas and 39 with miscellaneous tumors were examined. CA 19-9 and CA 125 were determined by immunohistochemistry (IH) applied to sections of the tumors and adjacent normal tissues. In parallel, the antigens were measured in the patients' sera by radioimmunoassay (RIA). By means of IH CA 19-9 and CA 125 were detected in normal surface cells from many different organs. Both antigens were also found in tissue sections of various types of tumors and in the sera of the corresponding patients. Thus, organ specificity could not be demonstrated. Sensitivity of CA 19-9 was found to be high for pancreatic carcinomas, i.e., 88% of the tumors expressed the antigen shown by IH and 85% of the sera revealed concentrations above the cut-off value (greater than 37 units/ml). Evidence for CA 125 was high in ovarian carcinomas with a tissue positivity in 83% and elevated (greater than 35 units/ml) serum levels in 70% of patients. Comparing IH and RIA case by case a discrepancy was found in 14% of cases with positive IH and low serum values a vice versa. Reasons for this finding are small tumor mass not producing elevated serum levels, retention of the antigen inside the tumor cells because of defective release mechanisms demonstrable only by IH, or heterogeneity of tumors with only focal antigen expression not present in the tissue sections investigated and thus disclosable only by RIA. The relevance of immunohistochemical detection of the antigens for therapeutic planning is discussed.     

Laparoscopic peritoneal lavage cytology and immunocytology in pancreatic and periampullary carcinoma

BackgroundFree tumour cells in the peritoneal cavity of patients with pancreatic carcinoma carry a poor prognosis. Reactive or degenerative mesothelial cells can make cytological interpretation with conventional stains difficult. Detection of the tumour-associated antigens carcinoembryonic antigen (CEA) and CA19-9 may improve detection.MethodsAt staging laparoscopy, 22 patients with pancreatic or periampullary tumours had ascitic fluid aspirated or peritoneal lavage performed. Both conventional and immunocytologically stained preparations were examined. Antibodies to CEA and CA19-9 and the epithelial marker BerEP4 were used. Lavage fluid from ten patients having operative treatment for benign pancreatic or biliary conditions was also examined.ResultsNo malignant cells on conventional cytological criteria were recovered.Thirteen of the 22 patients with pancreatic or periampullary carcinoma had peritoneal cells that were positive for CEA and/or CA19-9. None was positive for BerEP4. No patients with resectable disease had cells that were positive for CEA or CA19-9 compared with 13 of 18 (72%) who had unresectable disease. One patient (10%) with benign disease (chronic pancreatitis) had cells recovered that were weakly positive for CEA but negative for CA19-9 and BerEP4.DiscussionRecovery of cells from the peritoneal cavity of patients with pancreatic or periampullary carcinoma that are expressing the tumour-associated antigens CEA or CA19-9 does not indicate the presence of free tumour cells but is associated with advanced disease.     

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??Abstract??Objective To investigate the roles of tumor markers in diagnosis and prognosis assessment of patients with pancreatic carcinoma.Methods We collected 198 cases of pancreatic carcinoma??50 cases of benign pancreatic diseases and 61 cases of normal controls.Radioimmunoassay was used to detect the tumor markers such as CA19-9??CA242??CA125??CA50 and CEA.A total of 120 cases of pancreatic carcinoma were followed up and the factors influencing their prognosis were analyzed.Results The average levels of CA19-9??CA242 and CA125 in pancreatic carcinoma cases were significantly higher than those in the controls and benign pancreatic disease cases (P<0.05).We obtained sensitivities of 80.84%??72.50%??56.67%??56.12% and 45.31% for CA19-9??CA242??CA125??CA50 and CEA??respectively??and specificities of 76.80%??69.32%??72.96 %??65.33% and 57.40% for CA19-9??CA242??CA125??CA50 and CEA??respectively.Combined detection increased the sensitivity but reduced the specificity.The median survival time of the pancreatic cancer patients was 5.5 months.Patients with tumors located at pancreatic body??tail and the whole pancreas had less survival time than those with tumors located at pancreatic head and neck.Patients with higher levels of CA19-9??CA242 and CA125 had less survival time (P<0.05).Cox multivariate proportional hazards model showed that CA19-9 and CA242 were independent prognostic factors (P<0.05).Conclusion Early diagnosis of pancreatic carcinoma depends on serum examinations of tumor marker.Combined detection increases the sensitivity and reduces the specificity of the markers.Patients with tumor located at the pancreatic body??pancreatic tail??and with higher levels of CA19-9??CA242 and CA125 may have less survival time.CA19-9 and CA242 are independent prognostic factors that may help to assess the prognosis of pancreatic carcinoma.     

结直肠癌患者根治术前血清CEA和CA19-9表达水平对预后的预测价值

目的探讨结直肠癌患者根治术前CEA、CA19-9水平对预后的预测价值。 方法回顾性分析复旦大学附属肿瘤医院2003年12月至2007年1月间491例接受根治性切除的Ⅱ、Ⅲ期结直肠癌患者临床资料,包括患者术前血清CEA和CA19-9水平、临床病理资料及预后情况。利用单变量和多变量分析患者年龄、性别、肿瘤部位、肿瘤分化、TNM分期、肿瘤侵犯深度及淋巴结转移个数与预后的关系。 结果患者术前血清CEA和CA19-9水平、TNM分期、淋巴结转移数、肿瘤侵犯深度、肿瘤的分化都与预后相关。在多变量分析中,CEA和CA19-9水平、TNM分期、肿瘤分化是总生存的独立预测因素,CA19-9水平、TNM分期、肿瘤分化是无病生存的独立预测因素。 结论术前血清CA19-9与CEA水平均对结直肠癌患者的预后有预测价值。CA19-9水平应该作为常规的术前检查指标,对CEA检测结果有补充作用。     

重视胃癌和结直肠癌血清肿瘤标记物的临床价值

癌胚抗原（CEA）对胃癌和结直肠癌诊断的敏感性较低，相对特异性较高，其血清水平的监测有助于判断肿瘤的转移、根治疗效、复发和预后。糖链抗原（CA）72—4对胃癌、CA242和CA19—9对结直肠癌诊断的敏感性和特异性较高．可作为胃癌和（或）结直肠癌进展程度、术后疗效判断和预后评估的参考指标。血清胃癌抗原MG7和胃蛋白酶原对胃癌诊断有较高的敏感性和特异性，且对早期胃癌亦有较高的检出率。重视多种血清肿瘤标记物的联合检测．有利于提高肿瘤的诊断率。     

Relationship between autophagy and perineural invasion,clinicopathological features,and prognosis in pancreatic cancer

AIM To investigate the relationship between autophagy and perineural invasion(PNI), clinical features, and prognosis in patients with pancreatic cancer. METHODS Clinical and pathological data were retrospectively collected from 109 patients with pancreatic ductal adenocarcinoma who underwent radical resection at the First Affiliated Hospital of Zhengzhou University from January 2011 to August 2016. Expression levels of the autophagy-related protein microtubuleassociated protein 1 A/1 B-light chain 3(LC3) and PNI marker ubiquitin carboxy-terminal hydrolase(UCH) in pancreatic cancer tissues were detected by immunohistochemistry. The correlations among LC3 expression, PNI, and clinical pathological features in pancreatic cancer were analyzed. The patients were followed for further survival analysis. RESULTS In 109 cases of pancreatic cancer, 68.8%(75/109) had evidence of PNI and 61.5%(67/109) had high LC3 expression. PNI was associated with lymph node metastasis, pancreatitis, and CA19-9 levels(P 0.05). LC3 expression was related to lymph node metastasis(P 0.05) and was positively correlated with neural invasion(P 0.05, r = 0.227). Multivariate logistic regression analysis indicated that LC3 expression, lymph node metastasis, pancreatitis, and CA19-9 level were factors that influenced neural invasion, whereas only neural invasion itself was an independent factor for high LC3 expression. Univariate analysis showed that LC3 expression, neural invasion, and CA19-9 level were related to the overall survival of pancreatic cancer patients(P 0.05). Multivariate COX regression analysis indicated that PNI and LC3 expression were independent risk factors for poor prognosis in pancreatic cancer(P 0.05). CONCLUSION PNI in patients with pancreatic cancer is positively related to autophagy. Neural invasion and LC3 expression are independent risk factors for pancreatic cancer with a poor prognosis.     

Different types of intestinal metaplasia and gastric cancer: a clinico-endoscopic follow-up of 112 cases

The expression of 9 tumor-associated antigens (MG7-, MGd1-, MC3-corresponding antigens and CEA, P21ras, sialoglycoprotein, CA19-9-like, sialo-Tn and Lea-like antigens) were investigated on biopsy specimens with different types of intestinal metaplasia (types I, II and III) taken from 112 patients with benign gastric conditions. The incidences of positive staining for all antigens but P21ras in type III intestinal metaplasia were significantly higher than those in types I and II (P less than 0.05-0.001). These 112 patients with intestinal metaplasia were clinico-endoscopic followed-up for 15-70 months. Five of them were found to develop gastric carcinoma within 25-60 months with a cancer detection rate of 4.5%. All the five malignancies were detected in patients with type III (16.1%), none was found in those with types I and II, these differences were significant (P less than 0.05-0.01). Our results indicate that type III intestinal metaplasia has a higher potentiality to evolve to malignancy and that MG7, MGd1, MC3, CEA, CA19-9-like and sialo-Tn antigens are valuable tumor markers in defining the high-risk group of gastric cancer.     

Kinetics of carcinoembryonic antigen and carbohydrate antigen 19-9 production in a human pancreatic cancer cell line (SUIT-2)

Kinetics of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) production in a human pancreatic cancer cell line (SUIT-2) were investigated. Production of CEA reached a maximum, 31.0 ng/1 X 10(6) cells, in the late stationary phase with transient decline during the early exponential phase and 15.5% of the produced CEA was released into the medium, while production of CA19-9 reached a maximum, 421 U/1 X 10(6) cells, in the early stationary phase and 68.8% of the produced CA19-9 was released into the medium. Accordingly, the kinetics of CEA and CA19-9 production of SUIT-2 in vitro might be independent. CEA was stained immunohistochemically in the cytoplasm of the cells forming small buds above the monolayer cell sheet. On the contrary, CA19-9 positive cells were observed scattered in the monolayer cell sheet and CA19-9 was stained in the cytoplasm, predominantly at the projections of the cell surface. CEA and CA19-9 were also detected in the sera of nude mice bearing SUIT-2 tumors and their concentrations correlated well with tumor volume. Correlation coefficients between tumor markers and tumor volume were 0.79 (p less than 0.01) for CEA and 0.90 (p less than 0.01) for CA19-9.     

Carcinomatous and tuberculous pleural effusions. Comparison of tumor markers

As an aid in the differential diagnosis of exudative pleural effusions, tumor markers were investigated. We measured immunosuppressive acidic protein (IAP), carbohydrate antigen 19-9 (CA 19-9), tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), adenosine deaminase (ADA), and alpha 1-acid glycoprotein (AGP) in the pleural fluid of 36 patients with carcinomatous pleural effusions and of 35 patients with tuberculous pleurisy because we have frequently found these diseases to be associated with exudative pleuritis. Tuberculous pleural effusions had significantly higher levels of IAP, ADA, and AGP than carcinomatous effusions (p less than 0.005). On the other hand, CEA, CA 19-9, and TPA were significantly higher in carcinomatous pleural fluids than in tuberculous fluids (p less than 0.05). There was a correlation between IAP and AGP levels, and their specificity was low. Therefore, combined assays of CEA, CA 19-9, and ADA may be useful in distinguishing pleural effusions due to malignancies from those of tuberculous origin.     

Immunohistochemical Study of Colorectal Polyps with Antibodies against CEA,CA19-9, CA125, CA15-3 (DF3), PCNA and p53

Abstract: We analyzed the expression of CEA, CA19-9, CA125, CA15-3 (DF3), PCNA and p53 immunohistochemically in 14 tissue specimens of mucosal cancers in adenoma, seven tubulovillous adenoma specimens, and 16 tubular adenoma specimens. The rates of positive staining for mucosal cancer in adenoma, tubulovillous adenoma and tubular adenoma specimens, respectively, were: for CEA: 100%, 85.7% and 75%; for CA19-9: 71.4%, 71.4% and 56.2%; for CA125:0%, 0% and 0%;for CA15-3 (DF3): 64.3 %, 0% and 0 %; for PCNA: 100%, 88.9% and 56.2%; and for p53: 35.7%, 0% and 0% . The results suggest that the expressions of CEA, CA19-9, CA15-3 (DF3), PCNA and p53 are related to colorectal tumorigenesis. None of the specimens studied showed staining for CA125, suggesting that CA125 is not involved in the early stages of colorectal carcinogenesis. There was no significant difference in the rates of positive staining for CEA and CA19-9 among mucosal cancer in adenoma, tubular adenoma and tubulovillous adenoma specimens. However, the rates of positive staining for PCNA and p53 were significantly higher in mucosal cancer in adenoma specimens than for tubular adenoma specimens (p<0.05), and the rate of CA15-3 (DF3) positive staining was significantly higher for mucosal cancer in adenoma than for tubulovillous adenoma (p<0.01) and tubular adenoma (p< 0.001) specimens. Therefore, the CA15-3 (DF3) antigen is an immunohistochemical marker for colorectal carcinomas. The present results suggest that CA15-3 (DF3), PCNA and p53 play important roles in the genesis of colorectal adenomas.