CEA levels in patients with colorectal polyps

Authors

  • W. G. Doos MD,

    1. Mallory Gastrointestinal Research Laboratory, Mallory Institute of Pathology, Boston City Hospital; Boston University School of Medicine; Harvard Medical School, Boston, MA
    2. Departments of Surgery and Pathology, Beth Israel Medical Center, and Mount Sinai School of Medicine of the City University of New York, NY
    3. Boston City Hospital
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  • William I. Wolff MD,

    Corresponding author
    1. Mallory Gastrointestinal Research Laboratory, Mallory Institute of Pathology, Boston City Hospital; Boston University School of Medicine; Harvard Medical School, Boston, MA
    2. Departments of Surgery and Pathology, Beth Israel Medical Center, and Mount Sinai School of Medicine of the City University of New York, NY
    3. Beth Israel Medical Center
    • Beth Israel Medical Center, 10 Nathan D. Perlman Place, New York, NY, 10003; or Norman Zamcheck, MD, Mallory Gastrointestinal Research Laboratory, Boston City Hospital, Boston, MA 02118
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  • H. Shinya MD,

    1. Mallory Gastrointestinal Research Laboratory, Mallory Institute of Pathology, Boston City Hospital; Boston University School of Medicine; Harvard Medical School, Boston, MA
    2. Departments of Surgery and Pathology, Beth Israel Medical Center, and Mount Sinai School of Medicine of the City University of New York, NY
    3. Beth Israel Medical Center
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  • A. DeChabon MD,

    1. Mallory Gastrointestinal Research Laboratory, Mallory Institute of Pathology, Boston City Hospital; Boston University School of Medicine; Harvard Medical School, Boston, MA
    2. Departments of Surgery and Pathology, Beth Israel Medical Center, and Mount Sinai School of Medicine of the City University of New York, NY
    3. Beth Israel Medical Center
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  • R. J. Stenger MD,

    1. Mallory Gastrointestinal Research Laboratory, Mallory Institute of Pathology, Boston City Hospital; Boston University School of Medicine; Harvard Medical School, Boston, MA
    2. Departments of Surgery and Pathology, Beth Israel Medical Center, and Mount Sinai School of Medicine of the City University of New York, NY
    3. Beth Israel Medical Center
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  • L. S. Gottlieb MD,

    1. Mallory Gastrointestinal Research Laboratory, Mallory Institute of Pathology, Boston City Hospital; Boston University School of Medicine; Harvard Medical School, Boston, MA
    2. Departments of Surgery and Pathology, Beth Israel Medical Center, and Mount Sinai School of Medicine of the City University of New York, NY
    3. Boston City Hospital
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  • N. Zamcheck MD

    1. Mallory Gastrointestinal Research Laboratory, Mallory Institute of Pathology, Boston City Hospital; Boston University School of Medicine; Harvard Medical School, Boston, MA
    2. Departments of Surgery and Pathology, Beth Israel Medical Center, and Mount Sinai School of Medicine of the City University of New York, NY
    3. Boston City Hospital
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Abstract

Preoperative plasma CEA levels were measured in 93 selected patients with histologically defined colorectal adenomata removed at fibroptic colonoscopy in order to determine whether CEA levels are elevated in patients with colonic polyps, or vary with different histologic patterns. None of the patients had inflammatory bowel disease, previous history of carcinoma, or evidence of liver disease. Fifteen percent of the patients had elevated CEA levels (≥2.5 ng/ml; Hansen method), and two-thirds of these were between 2.5 and 4.0 ng/ml. Increased association of elevated CEA levels was noted with old age, villous adenomas (2-to 4-fold), and increased tumor size ((2.3-cm diameter; 2-fold), but not with foci of dysplasia or carcinoma in situ as such. One-half (7/14) of the patients with elevated CEA levels showed the following: two patients had villous tumors with carcinoma in situ, one had a villous adenoma, two had mixed villous and tubular adenomas (with a high proportion of villous pattern), and two were subsequently shown to have carcinoma elsewhere in the colon. It is uncertain that the polyps were the source of the elevated circulating CEA levels; other factors including smoking and patient selection need to be considered. This preliminary study suggests that patients with colorectal adenomata and elevated circulating CEA may be at higher risk for the development of carcinoma. Further follow-up studies of the malignant potential of the polyp-bearing colon are essential.

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