Carcinoembryonic Antigen (CEA)

CEA (Carcinoembryonic Antigen)

CEA is a cell adhesion molecule normally produced during fetal development. In adults, it is usually undetectable in the blood, but it may be re-expressed and elevated in certain cancers, including colorectal, gastric, pancreatic, breast, and lung cancers (Vrba et al., 1975).

šŸ§Ŗ Diagnostic Applications

  • CEA is widely used in colorectal cancer (CRC) for diagnosis, with high sensitivity and specificity, especially when combined with other markers such as irisin (Temur & Rashid, 2021).
  • Early postoperative CEA is a stronger prognostic indicator for stage II CRC than preoperative CEA or tumor stage, and may guide adjuvant therapy decisions (Du et al., 2022).
  • In gastric and colorectal cancers, CEA cut-off values <3 ng/mL yielded 100% sensitivity and specificity, making it a strong diagnostic tool (Temur & Rashid, 2021).

šŸ“ˆ Prognostic Value

  • Elevated postoperative CEA levels in CRC patients (even those with normal preoperative levels) correlate with worse survival and higher recurrence risk (Zhang et al., 2020).
  • Longer half-life of CEA after surgery predicts poorer outcomes in patients with preoperatively elevated levels (Yuan et al., 2008).
  • High CEA levels are also independently associated with worse overall survival in metastatic pancreatic cancer (Imaoka et al., 2016).

šŸ§Ŗ CEA in Non-Gastrointestinal Cancers

  • CEA is also detected in non-small cell lung cancer (NSCLC), but due to low sensitivity, it’s often combined with other markers for better predictive value (Liu & Bai, 2012).
  • Immunohistochemical localization patterns of CEA in cervical squamous cell carcinoma correlate with patient prognosis; central localization is linked to better survival (Toki & Yajima, 1991).

šŸ§Ŗ CEA in Biotechnology and Detection Methods

  • Biotechnological applications of CEA include its use in nanotechnology, photodynamic therapy, and drug delivery systems, especially for targeting colorectal liver metastases (Campos-da-Paz et al., 2018).
  • Aptamers and biosensors are being developed for ultra-sensitive detection of CEA, enhancing early cancer diagnosis (Melo et al., 2020), (Gholami et al., 2023).

āš ļø Limitations

  • CEA is not specific to cancerā€”elevated levels can occur in smokers, inflammatory conditions, and liver disease, which limits its standalone diagnostic utility.
  • Best used in monitoring and prognostic contexts, especially when combined with other markers or imaging.

āœ… Conclusion

CEA is a versatile and clinically valuable biomarker for gastrointestinal and some non-GI cancers. Its strength lies in prognosis and recurrence monitoring rather than initial diagnosis, and modern biotechnological tools are expanding its utility.

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