CARCINOEMBRYONIC ANTIGEN (CEA) IN TUMOR TISSUE, SERUM AND URINE IN CASES WITH TUMORS OF THE URINARY TRACT
A Study by Immunohistochemistry and Radioimmunoassay
1984 Volume 75 Issue 10 Pages 1558-1571
Details
1984 Volume 75 Issue 10 Pages 1558-1571
In order to evaluate the diagnostic and prognostic significance of carcinoembryonic antigen (CEA), an immunohistochemical study, using the peroxidase-antiperoxidase (PAP) method, of localization of CEA on tissue sections in one hundred and forty-six cases with primary tumors of the bladder, ureter, and renal pelvis was performed. In addition, in some of the cases, CEA values in serum, urine, and tumor tissue extract were also examined by radioimmunoassay.
The following results were obtained:
1) Immunohistochemically, CEA-positive tumor cells were found in 63 of 127 transitional cell carcinomas (TCC), 3 of 4 adenocarcinomas, and all of 5 squamous cell carcinomas, but not in any other malignant nor benign tumors.
2) Concerning the primary sites of the tumors, there was no significant difference in the incidence and distribution of CEA-positive tumor cells among TCC of bladder, ureter, and renal pelvis.
3) In TCC, CEA-positivity in the tumor cells correlated significantly to the histological grade (p<0.005), pathological stage (p<0.005), and occurrence of local recurrence (p<0.025). Therefore, CEA-positivity in the tumor cells seems to be a parameter for the malignant potentiality of the tumor.
4) In TCC of the bladder, there was no significant correlation between CEA-positivity in the tumor cells and values of serum and/or urinary CEA, showing that these three parameters are independent of each other.
5) In TCC of the bladder, although both values of serum and urinary CEA were not satisfactory as diagnostic information, the former was elevated significantly in cases with distant metastasis (p<0.05), and the latter in high stage cases with muscular invasion (p<0.05).
6) CEA was thought to be a more specific tumor marker in urachal carcinoma than in TCC because of its high concentration in the serum and tumor tissue extract. On the other hand, in mesonephric adenocarcinoma it was not detected immunohistochemically. These findings suggest embryologically different pathogeneses of the two adenocarcinomas.
