Immunoperoxidase staining for carcinoembryonic antigen (CEA) was performed on the tumors of 88 patients with epithelial ovarian cystadenocarcinomas treated at the University of Kentucky Medical Center from 1962 to 1975. Pretherapy plasma CEA determinations were obtained in 45 of these patients, and 4 0 had serial plasma CEA measurements following therapy. Cyst fluid CEA concentrations were measured in 14 patients. Immunoperoxidase staining indicative of a tissue CEA concentration of at least 3 pg/g was present in 21% of mucinous tumors and 2 % of serous tumors, representing a significant ( p < 0.01) difference ,between these two cell types. Cyst fluid CEA concentrations were above 1 pg/ml i n 75% of mucinous cystadenocarcinomas but in no serous tumors. Plasma CEA levels were related both to tissue and cyst fluid CEA concentrations and to the extent or stage of disease. Plasma CEA was highest in poorly differentiated mucinous tumors. All patients with progressively increasing plasma CEA levels developed recurrent ovarian cancer and died of their disease. Nine patients developed recurrent cancer despite having normal plasma CEA values, but none of the tumors of these patients contained measurable concentrations of CEA. Serial plasma CEA determinations most accurately reflected the clinical status of disease in those patients whose tumors contained high levels of antigen. Pretherapy plasma and tumor levels of CEA should be measured in order to identify those patients i n whom serial plasma CEA determinations following therapy will be useful to monitor the effects of therapy.
Cancer 41:2335-2340, 1978. ERY LITTLE IMPROVEMENT HAS BEEN MADE IN V the mortality rate of ovarian cancer over the past two decades, and, at present, this malignancy causes more deaths than any other gynecologic cancer. One major reason for this high mortality is the lack of an effective diagnostic method for early ovarian cancer. In fact, more than one half of patients with epithelial ovarian cancer have at least stage I11 disease at the time of initial clinical diagnosis. Much effort has been directed toward the development of an immuno-From the Division of Gynecologic Oncology, Department