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KMID : 0376219840210030583
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Chonnam Medical Journal
1984 Volume.21 No. 3 p.583 ~ p.599
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Immunohistochemical and Immunocytochemical Studies on the Carcinoembryonic Antigen (CEA)-Positive Tumor Cells in Gastric Adenocarcinomas
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Abstract
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Carcinoembryonic antigen (CEA), a useful oncofetal antigen for determination of prognosis and therapy monitoring in gastrointestinal cancer patients, has a limited value, because a considerable number of patients do not show elevated serum levels and CEA-positive cells are not always observed in the lesions. In gastric adenocarcinoma patients, serum CEA levels and CEA-positivity of tumor cells have been related to each other and they also have been related to the histopathological features of the carcinomas. The results, however, are not completely agreeable among the reporters. Also not ageeable is that whether CEA is cell membrane-associated antigen or intracytoplasmic antigen, which is an important debate for radiolocalization and tumoricidal targeting.
To study the relationship between histopathological features and CEA expression in the sera or in the lesions of gastric adenocarcinoma patients and to identify the CEA location in the tumor cells, preoperative serum CEA levels were assayed and the resected stomachs were examined histopathologically, immunohistochemically, and immunocytochemically in 12 patients. Serum CEA was determined by radioimmunoassay and CEApositive cells were observed with light and electron microscopes after immunoperoxidase staining by biotin-avidin system. The results were as follows.
1. In the lesions of the 5 patients with elevated serum CEA levels, the CEA-positive tumor cells with moderate to strong reaction were distributed diffusely. In those of the 7 patients with normal CEA levels, with one exceptional case, CEA reaction was negative or weakly positive; the CEA-positive tumor cells were distributed focally. Distribution and CEA reaction pattern of the positive cells were more or less uniform in the lesion of each case.
2. The better differentiated the tumor cells, the more strongly stained and more diffusely distributed the CEA-positive tumor cells. These findings had a positiive correlation with the elevated serum CEA levels.
3. There was no statistically significant relationship between the elevated serum CEA levels and the pathological types, size of the lesions, or presence of metastases.
4. No ultrastructural differences were identified between the CEA-positive and CEAnegative tumor cells. Immunocytochemically, CEA was observed to be intracytoplasmic antigen, probably related to the rough endoplasmic reticulum, rather than the cell membrane-associated one.
From these results, it was concluded that CEA positivity in the lesions of gastric adenocarcinoma patients reflected serum CEA levels so well that demonstration of intracytoplasmic CEA of tumor cells by immunoperoxidase staining might predict the usefulness of serum CEA determination in the patients.
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