Carcinoembryonic Antigen (CEA)

CPT: 82378
Print Share

Test Details

Use

This assay is intended for the in vitro quantitative determination of carcinoembryonic antigen in human serum and plasma.1 The Elecsys CEA assay is further indicated for serial measurement of CEA to aid in the management of cancer patients. The main indication for CEA determinations is the follow-up and therapy-management of colorectal carcinoma.

Limitations

CEA determinations are not recommended for cancer screening in the general population. CEA concentrations within the normal range do not exclude the possible presence of a malignant disease.

The measured CEA value of a patient's sample can vary depending on the test procedure used. CEA values determined on patient samples by different test procedures cannot be directly compared with one another and could be the cause of erroneous medical interpretations.

As with all tests containing monoclonal mouse antibodies, erroneous findings may be obtained from samples taken from patients who have been treated with monoclonal mouse antibodies or have received them for diagnostic purposes.1

In rare cases, interference due to extremely high titers of antibody to streptavidin and ruthenium can occur. The test contains additives which minimize these effects.1

For diagnostic purposes, the results should always be assessed in conjunction with the patient's medical history, clinical examination, and other findings.

Methodology

Electrochemiluminescence immunoassay (ECLIA)

Reference Interval

Range: 0−4.7 ng/mL; nonsmoker: <3.9 ng/mL; smoker: <5.6 ng/mL

Additional Information

CEA is a monomeric glycoprotein (molecular weight approximately 180,000 daltons) with a variable carbohydrate component of approximately 45% to 60%.1,2 CEA, like AFP, belongs to the group of carcinofetal antigens produced during the embryonic and fetal period. CEA is mainly found in the fetal gastrointestinal tract and in fetal serum. It also occurs in slight quantities in intestinal, pancreatic, and hepatic tissues of healthy adults. The formation of CEA is repressed after birth and, accordingly, serum CEA values are hardly measurable in healthy adults.

High CEA concentrations are frequently found in cases of colorectal adenocarcinoma.3,4 Slight to moderate CEA elevations (rarely >10 ng/mL) occur in 20% to 50% of benign diseases of the intestine, pancreas, liver, and lungs (eg, liver cirrhosis, chronic hepatitis, pancreatitis, ulcerative colitis, Crohn's disease, emphysema).3,5 Smokers also have elevated CEA values. The reactive epitopes of CEA have been characterized, and the available monoclonal antibodies classified, into six epitope groups.6-8 The antibodies used in the Elecsys CEA assay react with epitopes two and five. The antibodies react with CEA and (as with almost all CEA methods) with the meconium antigen (NCA2).8 Cross-reactivity with NCA1 is 0.7%.

Specimen Requirements

Specimen

Serum

Volume

0.8 mL

Minimum Volume

0.3 mL (Note: This volume does not allow for repeat testing.)

Container

Red-top tube or gel-barrier tube

Collection

If a red-top tube is used, transfer separated serum to a plastic transport tube.

Storage Instructions

Refrigerate.

Stability Requirements

Temperature

Period

Room temperature

7 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Citrate plasma specimen; improper labeling

Clinical Information

Special Instructions

Values obtained with different assay methodologies should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. This procedure does not provide serial monitoring; it is intended for one-time use only. If serial monitoring is required, please order the serial monitoring test (480095).

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Footnotes

1. CEA on Elecsys 1010/2010 and Modular Analytics E170 [package insert]. 2007-08, V15, Indianapolis, Ind: Roche Diagnostics; 2007.
2. Diamandis EP, Fritsche HA, Lilja H, et al. Tumor markers: Physiology, pathobiology, technology, and clinical applications. 1st ed. Washington, DC: AACC Press;2002.
3. Kuroki M, Haruno M, Arakawa F, et al. Reaction profiles of seven enzyme immunoassay kits for carcinoembryonic antigen (CEA) analyzed with purified preparations of CEA and related normal antigens. Clin Biochem. 1992; 25(1):29-35. 1551238
4. Sell SS. Serological cancer markers. Humana Press. 1992. ISBN 0-89603-209-4.
5. Stieber P, Fateh-Moghadam A. Sensible use of tumor markers. Boehringer Mannheim, Cat. N° 1536869 (Engl), 1320947 (German). ISBN 3-926725-07-9 German/English. Juergen Hartmann Verlag Marloffstein-Rathsberg (1993).
6. Thompson JA. Molecular cloning and expression of carcinoembryonic antigen gene family members. Tumor Biol. 1995; 16(1):10-16. 7863217
7. Hammarstrom S, Shively JE, Paxton RJ, et al. Antigenic sites In carcinoembryonic antigen. Cancer Res. 1989; 49(17):4852-4858. 2474375
8. Börmer OP, Thrane-Steen K. Epitope group specificity of six immunoassays for carcinoembryonic antigen. Tumor Biol. 1991; 12(1):9-15. 1705049

References

Greiner JW, Guadagni F, Goldstein D, et al. Evidence for the elevation of serum carcinoembryonic antigen and tumor-associated glycoprotein-72 levels in patients administered interferons. Cancer Res. 1991; 51(16):4155-4163. 1907881
Kiang DT, Greenberg LJ, and Kennedy BJ. Tumor marker kinetics in the monitoring of breast cancer. Cancer. 1990; 65(2):193-199. 2295042
Kudo R, Sasano H, Koizumi M, et al. Immunohistochemical comparison of new monoclonal antibody 1C5 and carcinoembryonic antigen in the differential diagnosis of adenocarcinoma of the uterine cervix. Int J Gynecol Pathol. 1990; 9(4):325-336. 1700970
Norton JA. Carcinoembryonic antigen. New applications for an old marker. Ann Surg. 1991; 213(2):95-97. 1992947
Rocklin MS, Senagore AJ, Talbott TM. Role of carcinoembryonic antigen and liver function tests in the detection of recurrent colorectal carcinoma. Dis Colon Rectum. 1991; 34(9):794-797. 1914746
Tatsuta M, Iishi H, Ichii M, et al. Diagnosis of gastric cancers with fluorescein-labeled monoclonal antibodies to carcinoembryonic antigen. Lasers Surg Med. 1989; 9(4):422-426. 2503669
Theriault RL, Hortobagyi GN, Fritsche HA, et al. The role of serum CEA as a prognostic indicator in stage II and III breast cancer patients treated with adjuvant chemotherapy. Cancer. 1989; 63(5):828-835. 2914290
Torosian MH. The clinical usefulness and limitations of tumor markers. Surg Gynecol Obstet. 1988; 166(6):567-579 (review). 2453934

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
002139 CEA 2039-6 002169 CEA ng/mL 2039-6

For Providers

Please login to order a test.

 

© 2017  Laboratory Corporation of America® Holdings and Lexi-Comp Inc. All Rights Reserved.

CPT Statement/Profile Statement

The LOINC® codes are copyright © 1994-2017, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf