Immunochemical Studies on Carcinoembryonic Antigen: (1) Quantitative Determination in Carcinomatous and Noncarcinomatous Tissues

Anti-CEA serum was prepared by immunizing rabbits with a crudeCEA fraction obtained from perchloric acid soluble extractsof adenocarcinoma of the stomach. After absorption, the antiserumproved to be monospecific for CEA. With Mancini's technique,CEA concentrations in perchloric acid extracts of carcinomatousand noncarcinomatous tissues were quantitatively determinedand expressed in terms of unit/ml, equivalent to mg/ml proteinconcentration of standard CEA solution. Finally, ratios of CEAunits per mg protein (CEA/P) of tissue extract were calculated. The CEA/P ratios tended to be higher in extracts from colonic,rectal and pancreatic carcinomas than in those from gastriccarcinoma, whereas they were lower in those from primary hepatomaand lung cancer. In the same patients with cancer, the ratiosfor carcinoma tissues were remarkably higher than those forthe noncarcinomatous counterparts. However, the ratios werenot related to the histological types of cancers. Relativelyhigh ratios were also observed in diseased intestinal mucosaof colonic polyposis and Crohn's disease, as well as in partsof gastric mucosa with a marked intestinal metaplasia obtainedfrom a cancerous stomach. More studies will be required to evaluatethe significance of occurrence in precancerous changes in tissues.     

A Case of Large Nonfunctioning Adrenal Cortical Carcinoma

An autopsy case of a nonfunctioning adrenal cortical carcinomais presented and the features of 16 cases with this tumor reportedbetween 1953 and 1977 in Japan are reviewed. This tumor predominantly afflicted males and the average ageof admission was 46.5 years. A palpable mass and abdominal painwere common symptoms. The average levels of 17-KS and 17-OHCSin the urine were 8.3 mg/24 hr and 4.6 mg/24 hr, respectively.The most common sites of distant metastases were the liver andlung. It was also noted that the only available mode of treatmentwas surgery.