CEA levels in fluids bathing gastrointestinal tumors

A controlled prospective study was undertaken to determine if fluids which bathe malignancies may contain carcinoembryonic antigen (CEA) earlier in the course of gastrointestinal cancer than does plasma of the same patient and may offer a better means for diagnosis. CEA titers were normal (less than 2.5 ng per ml) in the plasma of 42 healthy volunteers. Normal CEA levels were also found in the plasma and in the colonic mucus of 14, the gastric juice of 18, duodenal drainage of 10, and bile of 11 normal control subjects. The colonic mucus of 3 patients with ulcerative colitis, gastric secretions of 5 benign gastric ulcer patients, bile specimens from 11 normal control subjects and from 5 gallstone patients contained CEA at concentrations below 2.5 ng per ml. Positive CEA titers were found in the fluids bathing tumors of all 23 patients with colonic carcinoma, 9 of 17 patients with gastric carcinoma, and all 6 patients with pancreatic carcinoma. In contrast, positive CEA titers were found in the plasma of only 16 of 23 patients with colon carcinoma, 6 of 17 patients with gastric carcinoma, and 4 of 6 patients with pancreatic carcinoma. Among 46 patients with gastrointestinal malignancies, CEA was detected in significant concentrations in the plasma of 26 patients and in fluids bathing tumors of 38 patients. These results indicate a significant association of adenocarcinoma of the colon with CEA-positive colonic mucus (P less than 0.01) and suggest the usefulness of assaying CEA in fluids bathing tumors for the detection of gastrointestinal malignancies.