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INTRODUCTION: Active targeting of tumors by nanomaterials favors early diagnosis and the reduction of harsh side effects of chemotherapeuticals. METHOD: We synthesized magnetic nanoparticles (64 nm; -40 mV) suspended in a magnetic fluid (MF) and decorated them with anti-carcinoembryonic antigen (MFCEA; 144 nm; -39 mV). MF and MFCEA nanoparticles were successfully radiolabeled with technetium-99m (99mTc) and intravenously injected in CEA-positive 4T1 tumor-bearing mice to perform biodistribution studies. Both 99mTc-MF and 99mTc-MFCEA had marked uptake by the liver and spleen, and the renal uptake of 99mTc-MFCEA was higher than that observed for 99mTc-MF at 20h. At 1 and 5 hours, the urinary excretion was higher for 99mTc-MF than for 99mTc-MFCEA. RESULTS: These data suggest that anti-CEA decoration might be responsible for a delay in renal clearance. Regarding the tumor, 99mTc-MFCEA showed tumor uptake nearly two times higher than that observed for 99mTc-MFCEA. Similarly, the target-nontarget ratio was higher with 99mTc-MFCEA when compared to the group that received the 99mTc-MF. CONCLUSION: These data validated the ability of active tumor targeting by the as-developed antiCEA loaded nanoparticles and are very promising results for the future development of a nanodevice for the management of breast cancer and other types of CEA-positive tumors.

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OBJECTIVES: The purpose of this meta-analysis was to investigate the relationship between serum carcinoembryonic antigen (CEA) expression and epidermal growth factor receptor (EGFR) mutation status in non-small cell lung cancer (NSCLC). METHODS: Databases such as PubMed, Cochrane, EMBASE and Google Scholar were systematically searched to identify studies assessing the association of serum CEA expression with EGFR mutations. Across 19 studies, 4168 patients were included between CEA expression and EGFR mutations odds ratio (OR) conjoint analysis of correlations. RESULTS: Compared with CEA-negative NSCLC, CEA-positive tumors had an increased EGFR mutation rate (OR = 1.85, 95% confidence interval: 1.48-2.32, P < 0.00001). This association was observed in both stage IIIB/IV patients (OR = 1.60, 95% CI: 1.18-2.15, P = 0.002) and stage I-IIIA (OR = 1.67, 95% CI: 1.01-2.77, P = 0.05) patients. In addition, CEA expression was associated with exon 19 (OR = 1.97, 95% CI: 1.25-3.11, P = 0.003) and exon 21 (OR = 1.51, 95% CI: 1.07-2.12, P = 0.02) EGFR mutations. In ADC pathological type had also showed the correlation (OR = 1.84, 95% CI: 1.31-2.57, P = 0.0004). CONCLUSIONS: This meta-analysis indicated that serum CEA expression was associated with EGFR mutations in NSCLC patients. The results of this study suggest that CEA level may play a predictive role in the EGFR mutation status of NSCLC patients. Detecting serum CEA expression levels can give a good suggestion to those patients who are confused about whether to undergo EGFR mutation tests. Moreover, it may help better plan of the follow-up treatment.

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Background: There is very limited evidence on biomarkers for evaluating the clinical behavior and therapeutic response in rectal cancer (RC) with positive expression of cancer stem cells (CSCs). Methods: An exploratory prospective study was conducted, which included fresh samples of tumor tissue from 109 patients diagnosed with primary RC. Sociodemographic, pathological and clinical characteristics were collected from medical records and survey. The OCT4 protein was isolated using the Western Blot technique. It was calculated the ΔCEA, ΔOCT4, and ΔOCT4/GUSB values by assessing the changes before and after chemotherapy, aiming to evaluate the therapeutic response. Results: Patients had an average age of 69.9 years, with 55% (n=60) being male. Approximately 63.3% of the tumors were undifferentiated, and the most frequent staging classification was pathological stage III (n=64; 58.7%). Initial positive expression was observed in 77.1% of the patients (n=84), and the median ΔCEA was -1.03 (-3.82 - 0.84) ng/ml, with elevated levels (< -0.94 ng/ml) found in 51.4% of the subjects (n=56). Being OCT4 positive and having an elevated ΔCEA value were significantly associated with undifferentiated tumor phenotype (p=0.002), advanced tumor progression stage (p <0.001), and negative values of ΔOCT4 (p <0.001) (suggestive of poor therapeutic response) compared to those without this status. Conclusion: This study identified a significant and directly proportional association among the values of ΔCEA, ΔOCT4, and ΔOCT4/GUSB. These findings suggest that ΔCEA holds potential as a clinical biomarker for determining the undifferentiated tumor phenotype, advanced clinical stage, and poor therapeutic response in RC with CSCs positive expression.

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SUMMARY OBJECTIVE: This study purposed to evaluate preoperative two tumor markers, namely, carcinoembryonic antigen and carbohydrate antigen (CA)19-9, in colorectal cancer for anatomotopographic location with disease stage and to assess their utility for diagnostic staging purposes. METHODS: The study retrospectively incorporated patients who had undergone surgery for colorectal cancer at our department in 2015-2018 and in whom carcinoembryonic antigen and CA19-9 tumor markers had been preoperatively analyzed. The obtained data were then statistically processed using R-project. RESULTS: A total of 155 patients had been incorporated, of whom 96 (62%) were men and 59 (38%) were women. Rectum was the most common location (74 patients, 48%), and the least represented stage was IV (18, 12%). The marker carcinoembryonic antigen was obtained in all 155 cases, while CA19-9 was in 105. The median carcinoembryonic antigen was 3 (0.34-1104.25), and the median CA19-9 was 12 (0.18-840.00). A significance was recognized between median carcinoembryonic antigen and disease stage (p-value=0.016), with stages I, II, and III (medians 2, 3, and 2) different from stage IV (median 13), while no significance for CA19-9 was recognized (p-value=0.343). No significance between either marker and location (carcinoembryonic antigen: p=0.276; CA19-9: p=0.505) was detected. The testing was performed at a significance level of alpha=0.05. CONCLUSION: This study revealed a significance between the marker carcinoembryonic antigen, but not CA19-9, and the disease stage, while no relationship of either of these markers with tumor location was found. Herewith, the study confirmed that higher carcinoembryonic antigen values may suggest the finding of more advanced forms of colorectal cancer and thus a worse prognosis of this malignant phenomenon.

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El antígeno carcinoembrionario (CEA) es un marcador tumoral ampliamente empleado en el manejo del cáncer colorrectal, especialmente en el seguimiento de los pacientes resecados con intención curativa. El objetivo de esta revisión es actualizar el rol del CEA en el manejo de los pacientes intervenidos por un cáncer de colon estadios I-III considerando la mejor evidencia disponible. Dada la sensibilidad modesta en el tumor primario (40%), la cual sube al 60-80% en los casos de recidiva, se propone la medición precoz del marcador (alrededor del mes) de las resecciones R0, toda vez que el valor debiera estar normalizado, especialmente si estaba elevado en el preoperatorio. Una elevación sostenida o un alza > de 10 ng/ml en el control precoz es indicativo de enfermedad residual y/o a distancia, lo que implica un rastreo clínico intensivo. Aunque el CEA preoperatorio tiene un valor pronóstico categórico, el CEA postoperatorio precoz elevado parece tener un valor pronóstico de recidiva superior. Un seguimiento intensivo parece razonable en los pacientes con factores de riesgo de recidiva, lo que incluye la medición del CEA en forma seriada. El umbral óptimo del CEA es motivo de controversia, con una tendencia a bajar el nivel de corte considerado normal (< 5 ng/ml) en los últimos años), lo que podría mejorar el balance entre sensibilidad y especificidad del test. Nuevas técnicas como el ADN circulante en combinación con el CEA se han propuesto para mejorar la oportunidad del diagnóstico de una recidiva, actualmente en evaluación.

Carcinoembryonic antigen (CEA) is a tumor marker widely used in the management of colorectal cancer, especially in the follow-up of patients resected with curative intent. The objective of this review is to update the role of CEA in the management of patients operated on for stage I-III colon cancer considering the best available evidence. Given the modest sensitivity in the primary tumor (40%), which rises to 60-80% in cases of recurrence, early measurement of the marker (around a month) of R0 resections is proposed, since the value should be normalized, especially if it was elevated preoperatively. A sustained elevation or a rise > 10 ng/mL at early check-up is indicative of residual and/or distant disease, which implies intensive clinical follow-up. Although preoperative CEA has a strong prognostic value, elevated early postoperative CEA seems to have a higher prognostic value for recurrence. Intensive follow-up seems reasonable in patients with risk factors for recurrence, which includes serial CEA measurement. The optimal CEA threshold is controversial, with a tendency to lower the cut-off level considered normal (< 5 ng/ml) in recent years), which could improve the balance between test sensitivity and specificity. New techniques such as circulating DNA in combination with CEA have been proposed to improve the chance of diagnosing a recurrence, currently under evaluation.

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Gallbladder cancer (GBC) is commonly diagnosed at late stages when conventional treatments achieve only modest clinical benefit. Therefore, effective treatments for advanced GBC are needed. In this context, the administration of T cells genetically engineered with chimeric antigen receptors (CAR) has shown remarkable results in hematological cancers and is being extensively studied for solid tumors. Interestingly, GBC tumors express canonical tumor-associated antigens, including the carcinoembryonic antigen (CEA). However, the potential of CEA as a relevant antigen in GBC to be targeted by CAR-T cell-based immunotherapy has not been addressed. Here we show that CEA was expressed in 88% of GBC tumors, with higher levels associated with advanced disease stages. CAR-T cells specifically recognized plate-bound CEA as evidenced by up-regulation of 4-1BB, CD69 and PD-1, and production of effector cytokines IFN-γ and TNF-α. In addition, CD8+ CAR-T cells up-regulated the cytotoxic molecules granzyme B and perforin. Interestingly, CAR-T cell activation occurred even in the presence of PD-L1. Consistent with these results, CAR-T cells efficiently recognized GBC cell lines expressing CEA and PD-L1, but not a CEA-negative cell line. Furthermore, CAR-T cells exhibited in vitro cytotoxicity and reduced in vivo tumor growth of GB-d1 cells. In summary, we demonstrate that CEA represents a relevant antigen for GBC that can be targeted by CAR-T cells at the preclinical level. This study warrants further development of the adoptive transfer of CEA-specific CAR-T cells as a potential immunotherapy for GBC.

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Abstract Background: Inflammation, which is associated with an unhealthy lifestyle, plays a critical role in the development of both cardiometabolic diseases (CMD) and cancer. Carcinoembryonic antigen (CEA) is a tumor marker which also has proinflammatory properties. Recent studies have reported CEA to be associated with atherosclerosis, metabolic syndrome, and visceral adiposity. Epicardial adipose tissue (EAT) can exhibit highly inflammatory and pathogenic properties, and is a known risk factor for CMD. However, its relationship with CEA is still unknown. Objectives: This study aimed to investigate the possible association of CEA with EAT. Methods: A total of 134 Caucasian (males = 56, females = 78) individuals, aged (22-83 years), who were admitted for routine health control, were enrolled in this cross-sectional study. CEA was measured with chemiluminescent microparticle immunoassay (CMIA). EAT was measured by transthoracic echocardiography, and the visceral fat rating (VFR) was assessed by a body composition analyzing machine. The p-value <0.05 was considered statistically significant. Results: CEA levels were categorized as tertiles: T1, 0.5-1.04; T2, 1.06-1.69; and T3, ≥1.7 ng/ml. The mean age, weight, VFR, EAT, and fasting glucose, as well as the median of systolic blood pressure (SBP), creatinine, and AST increased with the increasing CEA tertiles. CEA was significantly associated with EAT (r = 0.55, P<0.001) and VFR (r = 0.36, P<0.001). Multivariate linear regression analysis confirmed that gender, age, and EAT were the significant independent variables associated with CEA. Conclusion: Individuals with increased EAT have higher levels of CEA, suggesting that this biomarker is most likely produced by EAT; however, additional investigations are required to improve the present work.

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Background: Clear cell carcinoma arising from the malignant transformation of endometriosis is a rare but aggressive cancer often diagnosed in perimenopausal women. Malignant transformation constitutes a rare complication of endometriosis, with only a few cases reported in the medical literature. Clear cell carcinoma and endometrioid carcinoma are the two most common histological subtypes associated with malignant endometriosis. Case Presentation: A 61-year-old Afro-Trinidadian woman underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for a degenerated uterine leiomyoma. Histopathology demonstrated an isolated finding of clear cell carcinoma occurring within an endometriotic cyst on the uterine serosa. Subsequent surgical staging demonstrated early-stage disease associated with a high-risk histological subtype and the patient was referred for adjuvant chemoradiotherapy. Conclusion: This case highlights the clinical manifestations and treatment modalities employed for an early-stage high-risk subtype of endometriosis-associated cancer. In light of the few publications on this clinical entity, we hope to raise awareness of this unique complication of endometriosis and contribute evidence to the development of standardized treatment protocols.

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Epidermoid cyst in an intrapancreatic accessory spleen is a rare benign lesion that is difficult to diagnose preoperatively. Cyst fluid analysis for biochemistry markers has been widely used to aid the diagnosis of pancreatic cysts. A high cyst fluid carcinoembryonic antigen (CEA) level (>800 ng/mL) is said to be useful in distinguishing intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN) from other non-mucinous cysts. We herein report a case of epidermoid cyst in an intrapancreatic accessory spleen with abnormally high CEA level (3582 ng/mL) in the cyst fluid, suggesting a potential pitfall in using cyst fluid CEA level as an indicator of mucinous neoplasms.

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The differential diagnosis of pancreatic cystic lesions (PCLs) includes non-neoplastic lesions and neoplastic epithelial lesions. Given that management is determined by the risk for malignant progression, associated symptoms, and other characteristics, an accurate diagnosis is imperative. The present review attempts to provide a critical path that facilitates the characterization and management of PCLs.

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SUMMARY BACKGROUND: Serum tumor markers are molecules that are secreted by tumor cells and may be present in small amounts in the serum of healthy individuals. Their role as prognostic factors in lung cancer remains controversial. OBJECTIVE: To assess the prognostic role of CEA, CA 19-9, CA 15-3, and CA 125 in non-squamous non-small cell lung cancer. PATIENTS AND METHODS: A total of 112 patients with non-squamous non-small cell lung cancer from two Oncology Centers were retrospectively analyzed. Tumor marker levels were measured prior to treatment. Data regarding clinical characteristics and overall survival were collected. RESULTS: Median overall survival of all patients was 15.97 months. Pre-treatment elevations of CA 125 and CA 15-3 were associated with shorter overall survival (p=0.004 and p=0.014, respectively). Single CEA and CA 19-9 elevations were not associated with a worse prognosis. Patients with two or more elevated markers had a statistically significant decrease in overall survival (p=0.008). In the multivariate analysis, smoking status and number of positive tumor markers at diagnosis were independently associated with a worse prognosis. CONCLUSION: High pre-treatment levels of tumor markers were correlated with decreased survival in patients with non-squamous non-small cell lung cancer.

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BACKGROUND: Carcinoembryonic antigen (CEA) in the pancreatic cystic fluid is the most important biomarker for differentiating mucinous from non-mucinous pancreatic cystic lesions (PCLs). However, recent studies have shown that glucose levels in pancreatic cystic fluid can discriminate mucinous from non-mucinous cysts. AIMS: To perform a meta-analysis to determine the utility of intracystic fluid glucose of pancreatic mucinous cysts compared with intracystic CEA. METHODS: We conducted a systematic review of the literature in the PubMed, OVID Medline, and Cochrane databases. This meta-analysis considers studies published up to October 2020. RESULTS: Six studies comprising 506 patients were selected; 61.2% of the population was female. Of the 480 PCLs, 287 (59.7%) were mucinous. Pooled sensitivity and specificity of cystic fluid glucose levels for mucinous PCLs were 91% and 85%, respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 6.33 and 0.11, respectively. Pooled diagnostic odds ratio (DOR) was 60.94. The pooled area under the summary receiver operating characteristic (SROC) curve was 0.959. Pooled sensitivity and specificity of pancreatic cystic fluid CEA levels were 61% and 93%. The PLR and NLR were 8.51 and 0.40, respectively. Pooled DOR was 23.52, and the pooled area under the SROC curve was 0.861. CONCLUSION: Glucose has become a useful method and appears to be better than CEA for differentiating between mucinous PCLs and non-mucinous PCLs. We suggest that the analysis of glucose in PCLs be routinely performed for the differential diagnosis of these lesions.

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As neoplasias mamárias caninas (NMCs) são as mais frequentes em cadelas, com isso, uma grande variedade de técnicas tem sido utilizada para identificar os seus fatores prognósticos. Dentre as possibilidades, os biomarcadores neoplásicos séricos antígeno do câncer (CA 15-3) e o antígeno carcinoembrionário (CEA) são os mais promissores. Biomarcadores neoplásicos são substâncias presentes na neoplasia, sangue ou demais produtos biológicos, produzidos pela neoplasia, ou secundariamente pelo paciente, em resposta à sua presença. Na medicina veterinária, esses marcadores são pouco estudados. Em termos gerais, eles não podem ser usados para o diagnóstico primário de neoplasias mamárias, mas estão relacionados com os fatores prognóstico já bem estabelecidos na literatura e tem como vantagem se tratar de uma análise menos invasiva e que é possível de ser feita de forma seriada. O objetivo desta revisão é descrever o CA 15-3 e o CEA como biomarcadores utilizados nas NMCs, o progresso recente feito na literatura e providenciar um sumário dos principais resultados já obtidos. O CA 15-3 e o CEA apresentam potencial prognóstico nas NMCs. Apesar de existir uma grande variação de resultados para esses biomarcadores na literatura, o seu uso deve ser considerado, visto os resultados obtidos na caracterização e prognóstico das NMC.(AU)

Female canine mammary neoplasms (CMNs) are the most frequent neoplasm in bitches, and a variety of techniques have been used to identify they prognostic factors. Among the possibilities, the serum biomarkers cancer antigen (CA 15-3) and carcinoembryonic antigen (CEA) are the most reliable. Neoplastic biomarkers are substances present in the neoplasia, blood, or other biological products, produced mainly by the neoplasia, or secondarily by the patient, in response to their presence. In veterinary medicine, these biomarkers are poorly studied. In general terms they cannot be used for primary diagnosis of mammary neoplasms but are related to the prognostic factors and have the advantage of being a less invasive analysis and that it is possible to be done in a serial way. The objective of this review is to describe CA 15-3 and CEA use as biomarkers in CMNs, the recent progress made in literature and the main overall results that had been already obtained. CA 15-3 and CEA have prognostic potential for CMNs. There is a wide variation of results for these biomarkers in literature, but despite this, its use must be considered as they provide relevant results in terms of characterization and prognostic in CMNs.(AU)

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Systemic therapy is generally required for breast cancer. However, treatment toxicity and side effects are a concern, especially for triple-negative breast cancer (TNBC), a subtype that usually develops resistance to chemotherapy. To overcome this issue, new nanoformulations capable of targeting cancer cells have been developed and alternative biomarkers have been explored as target molecules for TNBC management. In this study, we performed anin vivoassay in a murine orthotopic TNBC model to evaluate the targeting ability of anti-carcinoembryonic antigen (anti-CEA) loaded nanoparticles (labelled MFCEA), which had been previously synthetized by our research group. 4T1 cells were injected in the mammary gland of balb-c mice, and tumors were evaluated for CEA expression by immunohistochemistry. Tumor-bearing mice received targeted (MFCEA) and non-targeted (MF) nanoparticles intraperitoneally. Tumors were removed 1, 4, 15 and 24 h after treatment, and Prussian blue iron staining was performed. Our results showed, as far as we know for the first time, that 4T1 induced tumors are CEA positive, and this opens up new prospects for treating TNBC. Furthermore, MFCEA nanoparticles were able to target malignant tissue and were retained in the tumor for longer than MF nanoparticles. The retention property of MFCEA, together with the absence of toxicity observed in the MTT assay, make these nanoparticles a promising device for management of CEA positive tumors and perhaps for TNBC. Nevertheless, further studies must be carried out to improve their performance and ensure safety for clinical studies.

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The measurement of circulating tumour markers (TMs) for the diagnosis or monitoring of breast cancer has sometimes been considered of limited utility. In addition to the overinterpretation of irrelevant changes in marker levels, the characteristics of the patient, the disease or other pathologies that can modify them are often not considered in their evaluation. On the other hand, there are recent data on the relationship of TMs with molecular subtypes and on their prognostic value, the knowledge of which may improve their clinical utility. This consensus article arises from a collaboration between the Spanish Society of Laboratory Medicine (SEQCML) and the Spanish Society of Medical Oncology (SEOM). It aims to improve the use and interpretation of circulating TMs in breast cancer. The text summarizes the current knowledge and available evidence on the subject and proposes a series of recommendations mainly focussed on the indication, the frequency of testing and the factors that should be considered for correctly interpreting changes in the levels of TMs.

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INTRODUCTION AND OBJECTIVE: The purpose of this study was to investigate the expression levels and prognostic roles of α-fetoprotein (AFP), carcinoembryonic antigen (CEA), and Ki67 in tumor tissues of intrahepatic cholangiocarcinoma (ICC) patients. PATIENTS OR MATERIALS AND METHODS: The study involved ninety-two ICC patients with complete clinicopathological data and follow-up information, who had previously undergone radical surgery. AFP, CEA, CD10, CD34, and Ki67 were detected in tumor tissues using immunohistochemistry. Statistical tests were used to identify independent risk factors and their associations with overall survival (OS) and disease-free survival (DFS). RESULTS: AFP, CEA and Ki67 were strongly correlated with prognosis. Univariate analysis indicated that higher AFP (P = 0.002), CEA (P < 0.0001), Ki67 (P < 0.0001), CA19-9 (P = 0.039), and CA12-5 (P = 0.002), and larger tumor size (P = 0.001), as well as more advanced tumor node metastasis (TNM) staging (P < 0.0001) were all associated with worse OS. Meanwhile, higher AFP (P = 0.002), CEA (P = 0.001), and Ki67 (P < 0.0001), as well as more advanced TNM staging (P = 0.005) were associated with worse DFS. Multivariate analysis showed that higher AFP (HR = 2.004, 95%CI: 1.146-3.504 P = 0.015), CEA (HR = 2.226, 95%CI: 1.283-3.861 P = 0.004), and Ki67 (HR = 3.785, 95%CI: 2.073-6.909 P < 0.0001), as well as more advanced TNM staging (HR = 2.900, 95%CI: 1.498-5.757 P = 0.002) had associations with worse OS. Furthermore, higher AFP (HR = 2.172, 95%Cl: 1.291-3.654 P = 0.003), CEA (HR = 1.934, 95%Cl: 1.180-3.169 P = 0.009), and Ki67 (HR = 2.203, 95%Cl: 1.291-3.761 P = 0.004) had associations with worse DFS. CONCLUSION: High AFP, CEA, and Ki67 are significant prognostic indicators in ICC patients, and can be used to evaluate ICC biological behavior and prognosis.

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Resumen: Introducción: el antígeno carcinoembrionario (CEA) es un marcador tumoral de seguimiento y no una prueba de tamizaje y diagnóstico en cáncer colorrectal (CCR). Sin embargo, en la práctica clínica habitual se continúa solicitando con fines de diagnóstico inicial. Objetivo: evaluar el rendimiento del CEA para el diagnóstico de CCR en el Hospital Maciel y en la Cooperativa Médica de Florida, en el período 2000-2019. Material y método: se trata de un estudio prospectivo de evaluación del CEA como prueba diagnóstica del CCR. Los criterios de inclusión fueron: 1) videocolonoscopía total en los usuarios sin CCR y videocolonoscopía total o parcial para aquellos con CCR y la confirmación histológica de adenocarcinoma; 2) contar con determinación de CEA dentro de los 30 días previos o posteriores a la videocolonoscopía, y 3) para la estadificación, el informe anatomopatológico de la pieza quirúrgica y la confirmación histológica de metástasis a distancia. El número de casos incluidos se determinó por un mínimo de diez casos en cada celda de la tabla de contingencia. Resultados: se analizaron 211 casos. El análisis general determinó una sensibilidad de 33,6%, especificidad 70,4%, valor predictivo positivo (VPP) 69,1%, valor predictivo negativo (VPN) 35%, exactitud 45,9%. Para el estadio II, sensibilidad 18,8%, especificidad 70,4%, VPP 30%, VPN 56,2%, exactitud 49,5%. Estadio III: sensibilidad 31,6%, especificidad 70,4%, VPP 36,4%, VPN 65,8%, exactitud 56,8%. Estadio IV: sensibilidad 65%, especificidad 70,4%, VPP 55,3%, VPN 78,1%, exactitud 68,4%. Conclusiones: el CEA como prueba de confirmación diagnóstica del CCR muestra un bajo rendimiento, siendo aun menor en estadios precoces de la enfermedad.

Summary: Introduction: carcinoembryonic antigen (CEA) is a tumor marker used for follow up rather than a screening and diagnostic test for colorectal cancer (CCR). However, it continues to be requested in the regular clinical practice for initial diagnosis. Objective: to evaluate the effectiveness of CEA to diagnose colorectal cancer at Maciel Hospital and Cooperativa Medica de Florida Hospital from 2000 to 2019. Method: prospective study to evaluate CEA as a diagnostic test for colorectal cancer. The following inclusion criteria were used: 1) total videocolonoscopy in all users without CLC and total or partial videocolonoscopy for those with CRC and histologic confirmation of adenocarcinoma; 2) CEA determination within 30 days before or after videocolonoscopy and 3) for the purpose of staging, pathology report of the surgical piece and histological confirmation of distant metastases. The number of cases included was defined by a 10-case minimum in each cell of the contingency table. Results: 211 cases were analysed. The general analysis revealed 33.6% sensitivity, 70.4% specificity, VPP 69.1%, VPN 35%, accuracy 45.9%. In the case of staging II, sensitivity was 18.8%, specificity 70.4%, VPP 30%, VPN 56.2%, accuracy 49.5%. In the case of staging III, sensitivity 31.6%, specificity 70.4%, VPP 36.4%, VPN 65.8%, accuracy 56.8%. In the case of staging IV, sensitivity 65%, specificity 70.4%, VPP 55.3%, VPN 78.1%, accuracy 68.4%. Conclusions: CEA evidences low effectiveness to diagnose colorectal cancer, and it is still less effective in early stages of the disease.

Resumo: Introdução: o antígeno carcinogênico embrionário (CEA) é um marcador tumoral de acompanhamento e não um teste de rastreamento e diagnóstico em câncer colorretal (CRC). No entanto, na prática clínica de rotina, continua a ser solicitado nos diagnósticos iniciais. Objetivo: avaliar o desempenho do CEA no diagnóstico de câncer colorretal nos Hospitais Maciel de Montevidéu e da Cooperativa Médica de Florida, no período 2000-2019. Material e método: este é um estudo prospectivo avaliando o CEA como teste diagnóstico para câncer colorretal. Os critérios de inclusão foram: 1) videocolonoscopia total em usuários sem CCR e videocolonoscopia total ou parcial naqueles com CCR e confirmação histológica de adenocarcinoma; 2) determinação do CEA 30 dias antes ou após a videocolonoscopia e 3) estadiamento, laudo anatomopatológico da peça cirúrgica e confirmação histológica de metástases à distância. O número de casos incluídos foi determinado por um mínimo de 10 casos em cada célula da tabela de contingência. Resultados: foram analisados 211 casos. A análise geral determinou uma sensibilidade de 33,6%, especificidade 70,4%, VPP 69,1%, VPN 35%, precisão 45,9%. Para o estágio II, sensibilidade 18,8%, especificidade 70,4%, PPV 30%, NPV 56,2%, precisão 49,5%. Estágio III, sensibilidade 31,6%, especificidade 70,4%, PPV 36,4%, NPV 65,8%, precisão 56,8%. Estágio IV, sensibilidade 65%, especificidade 70,4%, PPV 55,3%, NPV 78,1%, precisão 68,4%. Conclusões: o CEA como teste de confirmação diagnóstica do câncer colorretal apresenta baixo desempenho, sendo ainda menor nos estágios iniciais da doença.

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PURPOSE: Tumor-associated antigens are a promising target of immunotherapy approaches for cancer treatments but rely on sufficient expression of the target antigen. This study investigates the expression of the carcinoembryonic antigen (CEA) on the surface of irradiated lung cancer cells in vitro using gold nanoparticles as radio-enhancer. METHODS: Human lung carcinoma cells A549 were irradiated and expression of CEA on the cell surface measured by flow cytometry 3 h, 24 h, and 72 h after irradiation to doses of 2 Gy, 6 Gy, 10 Gy, and 20 Gy in the presence or absence of 0.1 mg/ml or 0.5 mg/ml gold nanoparticles. CEA expression was measured as median fluorescent intensity and percentage of CEA-positive cells. RESULTS: An increase in CEA expression was observed with both increasing radiation dose and time. There was doubling in median fluorescent intensity 24 h after 20 Gy irradiation and 72 h after 6 Gy irradiation. Use of gold nanoparticles resulted in additional significant increase in CEA expression. Change in cell morphology included swelling of cells and increased internal complexity in accordance with change in CEA expression. CONCLUSIONS: This study showed an increase in CEA expression on human lung carcinoma cells following irradiation. Increase in expression was observed with increasing radiation dose and in a time dependent manner up to 72 h post irradiation. The results further showed that gold nanoparticles can significantly increase CEA expression following radiotherapy.

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Carcinoembryonic antigen (CEA) is a glycoprotein antigen generally used for diagnosis, prognosis and treatment monitoring of several types of tumors, including colorectal cancer. Nucleic acid aptamers are DNA or RNA oligonucleotides capable of binding with high specificity and affinity to a molecular target. The aim of this study was to obtain aptamers specific to CEA for use as radiopharmaceuticals in colorectal cancer diagnosis. Five aptamers were selected through the Systematic Evolution of Ligands by EXponencial Enrichment (SELEX) and tested using T84 (CEA+) and Hela (CEA-) cells. Apta 3 and Apta 5 showed the best results presenting high specificity and affinity for T84 cells, with dissociation constants (Kd) of 60.4 ± 5.7 nM and 37.8 ± 5.8 nM, respectively. These results indicate that Apta 3 and Apta 5 are promising candidates for identifying tumor cells that overexpress CEA.

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