Carcinoembryonic antigen in tissue and serum from breast cancer patients relationship with steroid receptors and clinical applications in the prognosis and early diagnosis of relapse

From July 1982 to August 1994, CEA levels were determined in 298 mammary ti ssue samples (30 benign, 242 primary breast cancer and 26 metastatic breast cancel;). CEA serum levels were also evaluated in 30 patients with benign diseases, 153 patients with primary breast cancer and 26 patients with meta states. CEA tissue levels in both pellet and cytosol were significantly hig her in samples from cancerous than from non malignant tissues (p < 0.0001), and higher in the pellet than in the cytosol (p < 0.0001). CEA in the pell et and cytosol were related to steroid receptors,with the highest levels be ing observed in ER+/PR+ tumors (p < 0.001). They were, however, not related to other pathological parameters such as tumor size or nodes. There was a correlation between CEA pellet and CEA serum in both patients with primary or metastatic tumors, with significantly higher CEA serum levels in patient s with CEA pellet positivity than in those with CEA pellet negativity. CEA serum levels were a prognostic factor (DFS and OS) in the whole group as we ll as in node-positive and node- negative breast cancer patients. This prog nostic value was only found in patients with CEA pellet positivity. In the follow-up of 143 NED patients, abnormal CEA serum levels rose prior to the diagnosis of relapse in 73% (29/40)of CEA pellet+ patients with distant rec urrences but in only 9% (2/22) of CEA pellet- cases (p < 0.0001). in summar y, CEA evaluation in tissue improves the CEA clinical application, selectin g those patients whose serum CEA will be useful in the prognosis and early diagnosis of recurrence.