Carcinoembryonic Antigen (CEA)

Carcinoembryonic Antigen (CEA)

Carcinoembryonic antigen (CEA) is a protein made by gastrointestinal cells. It is mostly made during fetal development (in the womb, before birth), and healthy adult levels are very low. CEA level is often increased in colorectal cancer (bowel cancer) and is considered a tumor marker of colon cancer and rectal cancer. CEA is secreted by colorectal adenocarcinoma cells and measured in the blood.

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What is Carcinoembryonic Antigen (CEA)?

 

 

Carcinoembryonic antigen (CEA) is a protein made by gastrointestinal cells. It is mostly made during fetal development (in the womb, before birth), and healthy adult levels are very low. CEA level is often increased in colorectal cancer (bowel cancer) and is considered a tumor marker of colon cancer and rectal cancer. CEA is secreted by colorectal adenocarcinoma cells and measured in the blood.

 

Can Carcinoembryonic Antigen (CEA) Levels Go Down?
 
 

The most effective way to lower CEA levels is to address the condition causing its abnormal increase. For example, if the elevated CEA is caused by cancer, surgically removing the malignant tumor allows for CEA to decrease to a normal level. Nonetheless, this could be attained if cancer has not spread to other tissues yet. Otherwise, CEA levels may remain high.

 

On the other hand, if the high CEA is due to other conditions outside cancer, treating the disorder could also normalize the protein secretion. Additionally, doing the following actions can aid in restoring wellness and help lower CEA levels naturally.

 

Stress management: Stress has long been associated with tumor growth, increasing CEA levels. On top of the treatment, avoid stress by employing techniques such as mindful breathing, meditation, and other stress-reducing activities.

 

Quit smoking: Studies have shown that CEA is higher among smokers than non-smokers. This can be due to chronic inflammation of the lung cells that are constantly exposed to tobacco. With that, if you got elevated CEA in your blood test, give up or avoid smoking at all costs.

Regular exercise: In a 2014 clinical trial, exercise was highlighted as a good way to reduce CEA expression. Light to moderate exercise is recommended two to three times a week. It's important to understand that heavy workouts can potentially cancel out the benefits of physical activities, especially among cancer patients.

 

Increase vitamin D: Maintaining sufficient vitamin D during your treatment can supplement its CEA-lowering mechanism. Spend some time receiving sunlight outdoors, ideally early in the morning. You can also include foods that help synthesize vitamin D in your diet, such as salmon, fortified foods, oranges, and egg yolk. If your doctor suspects vitamin insufficiency, you may be asked to take a vitamin D deficiency blood test.

 

Eating foods high in omega-3 fatty acids: Similar to vitamin D, omega-3 fatty acids can also help suppress CEA. You can enrich your diet with this essential nutrient by leaning toward foods such as fish (mackerel, sardines, herring, salmon), seafood, and seeds, like chia and flaxseeds.
Elevated CEA caused by cancerous tumors requires proper treatment and guidance from your physician. Before taking the said actionable tips, specifically, those involving supplementation, consult your doctor first.

 

Expression In Human Tumors Of Carcinoembryonic Antigen (Cea)
 

Carcinoembryonic antigen (CEA) is a cell surface glycoprotein which is overexpressed in various cancers but reported prevalence data vary considerably for many tumor types. Because of its overexpression in various cancer types and the limited expression in normal tissue CEA has become a potential drug target with several potential drug candidates currently being evaluated. CEA is also shed into the blood stream, so that CEA measurement in the serum is used as a tool for early detection and recurrence monitoring of cancer.

Methods

To comprehensively determine CEA expression in normal and neoplastic tissues, a tissue microarray containing 15,413 samples from 120 different tumor types and subtypes as well as 76 different normal tissue types were analyzed by immunohistochemistry.

Results

CEA was detectable in 65 (54.2%) of 120 tumor categories including 49 (40.8%) tumor types with at least one strongly positive case. CEA positivity was most common in colorectal adenomas (100%) and carcinomas (98.7%), other gastrointestinal adenocarcinomas (61.1%-80.3%), medullary carcinomas of the thyroid (96.3%), pulmonary adenocarcinoma (73.7%), mucinous carcinomas of the ovary (79.8%) and the breast (43.2%), squamous cell carcinomas of various sites (30.2%-69.1%), and small cell carcinomas of the lung (64.3%), the urinary bladder (38.9%), and the prostate (50.0%) as well as non-invasive papillary urothelial carcinoma pTa G3 (33,6%), pTa G2 high-grade (25,0%) and pTa G2 low-grade (5,7%). High CEA expression was linked to high grade tumors (p < 0.0001) and invasive growth (p < 0.0001) in urinary bladder cancer as well as estrogen receptor positivity (p = 0.0005) and HER2 positivity (p = 0,0158) in invasive breast cancer of no special type. In 1.250 colorectal adenocarcinomas, reduced CEA expression was associated with mismatch repair deficiency (p < 0.0001) but not with pT and pN stage. CEA expression level was unrelated to clinico-pathological tumor parameters in adenocarcinomas of the pancreas and the stomach, endometroid endometrium carcinoma as well as in serous and endometroid carcinomas of the ovaries.

 

Uses/Indications of Carcinoembryonic Antigen (CEA)
 

To monitor cancer treatment: Monitoring serial CEA levels can help track the effectiveness of treatment. If CEA levels are decreasing, it usually means a tumor is responding to treatment. If levels are increasing, it may mean the tumor is progressing. CEA is often ordered as a baseline test at the beginning of cancer treatment for this reason.

 

To monitor for recurrence of cancer: If CEA levels were normal and are increasing, it may mean that a tumor has recurred. A major use of the test is to detect relapse after curative treatment for colon cancer.

 

Cancer staging: Smaller tumors may have lower CEA levels, whereas larger tumors may have higher levels (greater tumor burden).

Understanding the stage of cancer is important in selecting the most appropriate treatments. A 2018 study found that CEA correlated well with the stage (at least stage I to III) of colon cancer.

 

To see if cancer has spread to certain areas: Spread (metastasis) to some regions of the body may cause much higher elevations of CEA. For example, metastasis to the pleural cavity (with a malignant pleural effusion), peritoneal cavity (within the abdomen), or the central nervous system often leads to very high CEA levels.

 

To estimate prognosis: Elevated levels of CEA after colon cancer surgery may indicate a poorer prognosis. CEA can also help estimate prognosis with non-small cell lung cancer and breast cancer.

 

As an adjunct (additional test) in diagnosis: While CEA levels cannot diagnose cancer, they are one puzzle piece that can help establish a diagnosis.

 

As a screening test for certain people: CEA levels are not considered useful diagnostic tools in the general population, but this test may be ordered to screen for cancer in people with some hereditary colorectal cancer syndromes.

 

In medical studies: A 2019 review of 19 studies notes that CEA may be a reasonable endpoint (a sign that a treatment is effective) in clinical trials looking for better treatments for metastatic colon cancer. In this meta-analysis, CEA response was strongly linked with overall survival.

 

Antibodies Of Carcinoembryonic Antigen (Cea)
 
 

An anti-CEA antibody is an antibody against CEA. Such antibodies to CEA are commonly used in immunohistochemistry to identify cells expressing the glycoprotein in tissue samples. In adults, CEA is primarily expressed in cells of tumors (some malignant, some benign) but they are particularly associated with the adenocarcinomas, such as those arising in the colon, lung, breast, stomach, or pancreas. It can therefore be used to distinguish between these and other similar cancers.

 

For example, it can help to distinguish between adenocarcinoma of the lung and mesothelioma, a different type of lung cancer which is not normally CEA positive. Because even monoclonal antibodies to CEA tend to have some degree of cross-reactivity, occasionally giving false positive results, it is commonly employed in combination with other immunohistochemistry tests, such as those for BerEp4, WT1, and calretinin.

 

For cancers that highly express CEA, targeting CEA through radioimmunotherapy is one of the therapy approaches.Engineered antibodies such as single-chain Fv antibodies (sFvs) or bispecific antibodies have been used for targeting and therapy of CEA expressing tumors both in vitro and in vivo with promising results Regions of high CEA levels in the body can be detected with the monoclonal antibody arcitumomab.

 

Our Factory
 

 

REALY has a dedicated development facility having a large pool of experienced scientists who are committed to development of IVD Reagents. Our R & D scientists are engaged in process development, process improvement, formulation and analytical development. This facility is recognized by State Food and Drug Administration, Government of China. COVID-19 Antigen Rapid Test Kits are our main product, including professional tests and home rapid test.

 

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FAQ

 

Q: What is CEA?

A: Carcinoembryonic antigen (CEA) is a protein marker found on some normal cells in adults, particularly in the colon, pancreas, and liver. It is also produced by cancerous cells in higher quantities, primarily associated with colorectal cancer but also present in cancers of the lung, breast, ovary, and pancreas.

Q: Why is measuring CEA important?

A: Measuring CEA levels is crucial in diagnosing certain types of cancers and monitoring the success of treatments. Elevated levels of CEA suggest the presence or progression of cancer.

Q: What does an elevated CEA level indicate?

A: An elevated CEA level may indicate the presence of cancer or recurrence after treatment. However, it is not definitive; false positives can occur due to smoking, inflammatory bowel disease, and chronic liver disease.

Q: Can CEA be used for screening purposes?

A: CEA is not typically used for general cancer screening because many non-cancer conditions can elevate CEA levels, leading to false alarms. It is more useful in follow-up care post-treatment for cancer patients.

Q: What level of CEA indicates cancer?

A: What levels of CEA indicate cancer? There's no magic number or threshold for a CEA test that points to cancer. Healthcare providers don't use the CEA test to screen for or diagnose cancer. In general, a CEA level of more than 2.9 ng/mL is considered abnormal but doesn't necessarily mean that cancer is present.

Q: How is CEA measured?

A: CEA is measured through a blood test known as a CEA assay. A small sample of blood is drawn, and the serum is analyzed for CEA levels.

Q: Is there a correlation between CEA levels and tumor size?

A: In some cases, yes-there is a rough correlation between the concentration of CEA and the extent of the tumor. However, this varies greatly depending on the individual and the type of cancer.

Q: Is CEA a good tumor marker?

A: The test is often used with other tests to check if cancer treatment is working. CEA tests are not used to screen for or diagnose cancer. That's because: Cancers that often cause high CEA levels don't always cause high levels.

Q: Can lifestyle factors affect CEA levels?

A: Yes, smokers tend to have slightly higher baseline CEA levels compared to nonsmokers, even without cancer. Other factors like chronic liver disease can also elevate CEA levels.

Q: Does chemotherapy influence CEA levels?

A: Chemotherapy can lower CEA levels during successful treatment phases. Conversely, rising CEA levels during therapy may signal resistance or failure of the treatment regimen.

Q: Should I get regular CEA tests if I don't have cancer?

A: For individuals without cancer or strong risk factors, routine testing for CEA is generally not recommended. It is primarily used for surveillance in diagnosed cancer patients.

Q: What happens if CEA levels rise suddenly after treatment?

A: Rising CEA levels after cancer treatment can indicate possible recurrence or spread of the cancer. Your doctor will likely recommend imaging studies or additional tests to investigate.

Q: Can CEA distinguish between benign and malignant tumors?

A: While CEA can be indicative of malignancy, it cannot definitively differentiate benign from malignant tumors. Additional diagnostic methods are required for confirmation.

Q: What alternatives are there if CEA is inconclusive?

A: If CEA results are unclear or misleading, other biomarkers like CA 19-9, CA 125, or CA 15-3 can be tested, depending on the suspected cancer type. Imaging studies and endoscopic examinations are also valuable tools.

Q: How frequently should CEA levels be monitored in cancer patients?

A: The frequency of CEA monitoring varies based on the stage of cancer and response to treatment. Typically, it's done every three to four months initially, then less frequently with continued stability.

Q: Can CEA levels fluctuate naturally over time?

A: Yes, CEA levels can fluctuate daily or weekly, although significant changes over longer periods are more relevant. Fluctuations under clinical supervision are closely watched for trends indicating cancer activity.

Q: Are there any risks involved with taking the CEA test?

A: There are minimal risks associated with the CEA test itself. As it involves a blood draw, minor bruising or infection can occur at the puncture site, similar to any venipuncture procedure.

Q: Why would a doctor order a CEA test?

A: This test is done to monitor the response to treatment and then to check for the return of colon and other cancers such as medullary thyroid cancer and cancers of the rectum, lung, breast, liver, pancreas, stomach, and ovaries.

Q: Does CEA affect the choice of treatment?

A: CEA levels can guide treatment decisions, particularly in determining the efficacy of ongoing therapies or the introduction of new ones in cases where levels persistently rise.

Q: What CEA level is benign?

A: Elevated circulating CEA levels occur in patients with benign gastrointestinal and hepatic disorders. These are usually less than 10 ng/ml. Of clinical importance is the influence of liver disease on the interpretation of CEA.

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