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Carcinoembryonic antigen (CEA) in clinical medicine. Historical perspectives, pitfalls and projections
Author(s) -
Gold Phil,
Shuster Joseph,
Freedman Samuel O.
Publication year - 1978
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197809)42:3+<1399::aid-cncr2820420803>3.0.co;2-p
Subject(s) - carcinoembryonic antigen , medicine , intensive care medicine , cancer
Carcinoembryonic antigen (CEA) was first detected by the immunization of rabbits with human colon cancer extract. The techniques of antiserum absorption and immunologic tolerance were employed in an attempt to render the resulting antisera tumor‐specific. Using the procedures of precipitation and precipitin‐inhibition in gel media, hemagglutination, passive cutaneous anaphylaxis and immunofluorescence, CEA was identified exclusively in all cancers of gastrointestinal origin and fetal digestive organs in the first two trimesters of gestation. The subsequent development of radioimmunoassays for CEA has raised the question of the presence of this material, in very low concentrations, in other normal and diseased (cancerous and noncancerous) tissue, but the problem of cross‐reactivity within a family of closely related, but nonidentical, molecules remains to be resolved. CEA was initially purified by a sequence of steps involving extraction in perchloric acid, sieve chromatography, and preparative block electrophoresis. The molecule was characterized as a relatively heterogeneous acid glycoprotein with a molecular weight of approximately 200,000 and its carbohydrate (one‐half to two‐thirds of the molecule) and protein composition were determined. CEA was localized to the glycocalyx of the colon cancer cell and it was found that the CEA could be released from this site into the circulation of the cancer patient, where it could then be detected by means of radioimmunoassay. The clinical implications of this observation, as they have evolved over the past eight years, form the basis of the papers that constitute this supplement.