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Since Gold and Freedman discovered the carcinoembryonic antigen(CEA) in 1965, CEA had been used as atumor marker of gastrointestinal carcinoma especially in the colorectal carcinoma for the evaluation of surgical treatment and pornosis. however, the knowlege on CEA in the fetal tissue is still incomplete. In this study CEA on the fetal gut epithelium was examined from the 6th to the 40th week to evaluate its sequential progression and correkation with adult gastrointestinal carcinoma by using immunoperoxidase (peroxidase-antiperoxidase)method. The materials were embryonic to early fetal guts(4 cases), colon(61 cases),small intestine(52 cases) and stomach(18 cases) of fetuses, and adenocarcinomas of the colon(12 cases) and stomach(14 cases),and adenomatous polyps of colon(6 cases) in adults. The results obtained were as follows: A. CEA of the gut epithelium of the emoryo and fetus 1. CEA of the embrtonic and early fetal gut epithelia was demonstrated intracellularly as well as along the luminal border by the 6th week of gestation. 2. CEA of colon was demonstrated in the cells and along the luminal border, by the 16th week of gestation. This was progressively increased in its activity to reach the peak by the 19th to 23rd week, and gradually decreased by the 37th week in the cytoplasmic activity. However, the surface activity was still present by the 40th week of gestation. 3. CEA of small intestine was demonstrable by the 17th week along the luminal surface and by the 19th week intracellularly. Its activity was progressively decreased by the 30th week although the surface was positive until 40th week of gestation. 4. CEA of stomach was demonstrated in the cells and along the luminal border by the 19th week. The activity was progressively increased to reach the peak by the 24th to 28th week, and was decreased by the 31st week both in the surface and cytoplasmic CEA. B. CEA of adenocarcinoma of colon, stomach, and adenomatous polyp of colon 1. Well differentiated adenocarcinoma of colon and stomach showed those of poorly differentiated adenocarcinoma or signet ring cell carcinoma. There was no difference in CEA activity between stomach and colon adenocarcinoma. Among the mucin pools seen in mucinous adenocarcinoma positive CEA reaction could be demonstrated only near the tumor cell nests. Slight increase of CEA acticicity was seen in hyperplastic or mataplastic epithelium near the carcinoma and adenomatous polyp. 2. CEA activity was increased slightly in adenomatous polyps compared to those of normal mucosa, but it was lower in its activity than those of carcinoma cells. In summary, the carcinoembryonic antigen could be demonstrable though nearly entore fetal life,reaching its peak by the 19th to the 23rd week of gestation. Thereafter the activity was progressively decreased to become almost negligible by term. CEA was increased in the hyperplastic epithelial cells as well as adenocarcinoma cells of both stomach and colon. those findings suggest that the neoplastic cells of gastointerinal adenocarcinoma represent the cells in differentation toward the embryonic to fetal gut epithelial cells thus gaining the increased producibility of CEA.
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