Carcinoembryonic antigen (CEA) levels in benign gastrointestinal disease states

✍ Scribed by M. S. Loewenstein; N. Zamcheck

• Publisher: John Wiley and Sons
• Year: 1978
• Tongue: English
• Weight: 562 KB
• Volume: 42
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(197809)42:3+<1412::aid-cncr2820420805>3.0.co;2-8

✦ Synopsis

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. At least 50% of patients with severe benign hepatic disease have elevated CEA levels, most often active alcoholic cirrhosis, and also chronic active and viral hepatitis, and cryptogenic and biliary cirrhosis. Patients with benign extrahepatic biliary obstruction may have increased plasma CEA, the highest in patients with coexistent cholangitis and especially liver abscess. The liver appears to be essential for the metabolism andor excretion of CEA. Hence, liver work-up is needed to assess any patient with an elevated CEA. A damaged liver may further augment elevated CEA levels due to cancer. The increased circulating CEA observed in some patients with active ulcerative colitis tends to correlate with severity and extent of disease and usually returns to normal with remission. CEA levels also may be mildly elevated in patients with pancreatitis and in adults with colonic polyps. Smoking may contribute to the increased CEA levels seen in patients with alcoholic liver disease and pancreatitis. Therefore, in interpreting mildly elevated circulating CEA levels in patients with GI tract diseases, one must consider benign as well as malignant etiologies.