Carcinoembryonic Antigen (CEA)

Immunology

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Description

The main application of all tumour markers is monitoring for relapse or progression. Use as a diagnostic aid requires care and knowledge of the test limitations. Opportunistic screening is discouraged. Measurement of carcinoembryonic antigen (CEA) is primarily carried out in the pathological staging of colorectal cancer (CRC) [2]. Due to the lack of specificity and sensitivity of the assay for early disease, CEA cannot be used for either screening or diagnosis of CRC. Guidelines suggest that this test is used for staging, detecting recurrence and monitoring therapy and screening for hepatic metastases [1,3]. Elevated levels have been detected in a number of malignant and non-malignant conditions of the gastrointestinal tract and other sites. These conditions include various hepatic diseases, inflammatory lesions - particularly of the gastrointestinal tract, infections, trauma, infarction, collagen vascular disease, renal impairment and smoking (current and past) [4]. CEA also occurs at low levels in normal colonic and other tissues. Benign diseases rarely give rise to CEA levels >10�g/L. CEA levels are considered suggestive of cancer in patients when serum values exceed five times the normal range, and the patient presents with the appropriate symptoms [4].

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Indications

Pathological staging of colorectal cancer. CEA has a limited role in primary diagnosis of malignancy, however regular or sequential assay may have a role in the detection of recurrent disease, prognosis or in the monitoring of tumour therapy.

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Sample Type

2mL Serum (Gel 5mL Yellow tube) or 2mL EDTA Plasma.
Requests from outside Sheffield: transport at ambient temperature via Royal Mail or Courier.

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Reference Range

< 2.5 ug/L in non-smokers.
3.5 - 10 ug/L in smokers.

Reference range established by manufacturer and verified in house.

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Turnaround Time

Within 2 days

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Testing Frequency

Daily

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References

Sturgeon CM and Diamandis EP. Use of tumour markers in clinical practice: Quality requirements. The National Acadamy of Clinical Biochemistry. Laboratory medicine practice guidelines. 2009. [Ref 1].
Sturgeon CM et al. Serum Tumour Markers: How to order and interpret them. British Medical Journal. 2009. 339: 852-858.
Wilkes G, and Hartshorn K. Colon, rectal and anal cancers. Seminars in Oncology nursing. 2009. 25(1): 32-47.[Ref 2].
Duffy MJ, et al. Clinical utility of biochemical markers in colorectal cancer: European Group on Tumour Markers (EGTM) guidelines. Eur J Cancer. 2003. 39(6):718-727. [Ref 3].
Duffy MJ. Carcinoembryonic antigen as a marker for colorectal cancer: Is it clinically useful? Clin Chem. 2001. 47(4):624-630. [Ref 4].
Duffy M.J. Tumour Markers in Clinical Practice: A review focusing on common solid cancers. Med Princ Pract. 2013. 22: 4-11.

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Please note: the above information is subject to change and we endeavour to keep this website up to date wherever necessary.