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CEA is an antigen present in the intestinal cells of the fetus and when it is an adult, it is found in very low concentrations in the blood. When patients have cancer, especially carcinoma, CEA levels increase. Other cancers such as colorectal, stomach, lung, pancreatic... May increase CEA.
1. What is the normal CEA?
1.1 Plasma CEA The plasma CEA value in a normal non-smoker is usually <2.5 ng/ml. CEA values in smokers are usually <5 ng/ml. The plasma CEA value in people with benign disease is usually not more than 10 ng/ml. 1.2 CEA in body fluids In general, the CEA value in the aspiration fluids of people without cancer is close to the CEA value in normal human plasma, namely:
The peritoneal fluid CEA value in in non-cancerous subjects < 4.6 ng/mL, the cut-off value was < 5.0 ng/ml. The CEA value of pleural fluid in a non-cancerous person has a cut-off value of 2.4 ng/ml. The CEA value of cerebrospinal fluid in a non-cancerous person is 1.53±0.38 ng/ml. 1.3 How much CEA is dangerous? Normal CEA concentration is 0-5 ng/ml. The percentage of cancer patients with elevated CEA > 5 ng/ml depends on different organs but usually ranges from 50-70%.
CEA is increased in certain types of cancer, especially colon cancer (colorectal cancer and rectal cancer). CEA may also be increased in people with pancreatic, breast, ovarian, or lung cancer.
2. Who needs a CEA test?
Xét nghiệm CEA có thể được chỉ định khi một người đã được chẩn đoán ung thư đại trực tràng, dạ dày
The CEA test may be ordered when a person has been diagnosed with colorectal, stomach, or lung cancer. CEA will be quantified prior to initiation of treatment and then tested over time to assess treatment efficacy, prognosis, and detect recurrence and metastasis.
Sometimes a CEA test may be done when cancer is suspected but has not been diagnosed. It is not a universal test for cancer because CEA can be elevated in many different conditions, however it may still be ordered to provide additional diagnostic information depending on the clinical picture. specific sieve.
Body fluid CEA testing may be ordered to detect tumor that has invaded or metastasized to body cavities (eg, metastasis has spread to the peritoneal cavity, pleura, or brain).
3. Clinical significance of CEA
3.1 Screening and Early Diagnosis The clinical sensitivity of CEA for the diagnosis of colorectal cancer is 50%, the specificity is 90%.
Prognosis CEA values tend to get higher as the disease progresses. Use a cutoff point of 5 ng/ml.
In colorectal cancer, the CEA value can be used to predict and detect residual tumor after surgery. The preoperative CEA value is also a prognostic value and determines the stage of the tumor. In general, tumors with high CEA values have a very poor prognosis.
Monitoring treatment response and detecting recurrence After colorectal cancer surgery, plasma CEA values will gradually decrease and return to normal in 4 to 6 weeks. In colorectal cancer, plasma CEA series testing is the most sensitive noninvasive method for the diagnosis of tumor recurrence after resection of the primary tumor.
For each patient, an initial plasma CEA value was determined as a baseline for monitoring disease progression. When the CEA Value is persistently increased for at least 2 months, there is a possibility that the cancer will recur.
Detection of metastases If CEA is increased in body fluids, it is very likely that the cancer has invaded nearby areas or metastasized to corresponding areas of the body. For example, if CEA is found to be elevated in the pleural effusion, the cancer may have spread to the lungs or pleura; if CEA is found to be elevated in the peritoneal fluid, the cancer may have spread to the peritoneum; If CEA is found to be elevated in the cerebrospinal fluid, the cancer may have spread to the spinal cord or brain.
In other cancers such as gastric, esophageal, pancreatic, lung, ovarian, medullary thyroid... CEA values only increase as the cancer progresses, the rate of increase is about 50-70 % of cases .
3.2 CEA in benign diseases CEA values can also be increased in some benign diseases, causing false positives, such as pneumonia, emphysema, hepatitis, cirrhosis, gastric ulcer duodenal ulcer, ulcerative colitis, rectal polyps, benign breast disease...
4. Some factors affecting the CEA
Hút thuốc lá nhiều có thể gây ảnh hưởng đến nồng độ CEA
High blood CEA can't conclude cancer because there are many causes affecting CEA levels:
Urogenital carcinoma Gastroenteritis (such as ulcerative colitis, diverticulitis) , cholecystitis, pancreatitis) Cirrhosis Other liver diseases Inflammation, stomach ulcers Heavy smoking Lung infections Pneumonia Pancreatitis Excessive bleeding (rare) Fainting or feeling dizzy Hematoma (blood) accumulation under the skin) Infection. Thus, just relying on a high CEA cannot accurately assess the disease you are experiencing. For the most accurate diagnosis, it is best to bring the results of your examination to your doctor. After the clinical examination and review of the results, if any abnormality is found, the doctor may order to perform some other tests such as: X-ray, ultrasound, biopsy...
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