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Abstract

THE ROLE OF CARCINOEMBRYONIC ANTIGEN (CEA) IN DIAGNOSIS AND FOLLOW UP IN COLON CANCER

*Dr. Haydar Abd Al-Kader Al-Jawadi and Dr. Suhail Younis Ahmed

ABSTRACT

Since the recognition of carcinoembryonic antigen (CEA) as a marker for colorectal cancer, its clinical application to screening, diagnosis, prognosis, and monitoring has been extensively investigated. CEA, a normal cell product that is overexpressed in adenocarcinoma, was first identified as a potential tumor marker in 1965 by Gold and Freedman.[1] CEA is a family of related glycoproteins that may function as a metastatic potentiator through alterations in immune responses, adhesion characteristics, and cellular migration.[2] CEA is overexpressed in carcinomas, primarily of the colon, rectum, breast, and lung, although it can also be detected in the serum of patients with a variety of nonmalignant disorders.[3] Because CEA is cleared by the liver, an elevation of serum CEA level can be observed in patients with alcoholic cirrhosis, cholelithiasis, obstructive jaundice, cholangitis, and liver abscess. Smokers and patients with such chronic lung diseases as emphysema and bronchitis generally have higher circulating CEA concentrations than do nonsmokers. Benign diseases of the gastrointestinal tract, including gastric ulcer, gastritis, and diverticulitis, are associated with increased CEA. In one study of 25 patients with noncancerous inflammatory bowel disease, the mean serum CEA was found to be twice normal.[4] Although CEA elevations have been reported in nearly every type of solid tumor, it is in neoplasms of the colon and rectum that this tumor marker has proven to be the most useful

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