OBJECTIVE: The diagnostic impact of carcinoembryonic antigen (CEA) was evaluated in serum and CSF of cancer and control patients. METHODS: 97 analyses of CEA in CSF and serum from 83 cancer patients were compared with 41 cases without malignancy. CEA diffusion dynamics were evaluated with IgA CSF/serum quotients (Q IgA). Intrathecal synthesis of CEA was analysed both by calculating an index Q CEA/Q IgA and within the IgA-diagram. RESULTS: In 73 samples without synthesis of IgA or CEA, both quotients correlated well with a mean Q CEA/Q IgA of 1.1 (95% CI 0.97-1.2). The Q CEA/Q IgA was significantly higher in metastasizing adenocarcinomas than in controls or other malignancies. In leptomeningeal disease from adenocarcinoma, Q CEA/Q IgA was significantly higher than in controls, while patients with CNS and/or bone metastases had intermediate values. The sensitivity to detect leptomeningeal disease was 91% and 69% for brain metastases. Q CEA/Q IgA and CEA synthesis assessed with the IgA diagram were equally sensitive. CONCLUSIONS: Evaluation of CEA in the IgA diagram is feasible and of clinical value. The consideration of intrathecal CEA synthesis correlates better with the clinical status than absolute CSF-CEA or the correlation with albumin.
OBJECTIVE: The diagnostic impact of carcinoembryonic antigen (CEA) was evaluated in serum and CSF of cancer and control patients. METHODS: 97 analyses of CEA in CSF and serum from 83 cancerpatients were compared with 41 cases without malignancy. CEA diffusion dynamics were evaluated with IgA CSF/serum quotients (Q IgA). Intrathecal synthesis of CEA was analysed both by calculating an index Q CEA/Q IgA and within the IgA-diagram. RESULTS: In 73 samples without synthesis of IgA or CEA, both quotients correlated well with a mean Q CEA/Q IgA of 1.1 (95% CI 0.97-1.2). The Q CEA/Q IgA was significantly higher in metastasizing adenocarcinomas than in controls or other malignancies. In leptomeningeal disease from adenocarcinoma, Q CEA/Q IgA was significantly higher than in controls, while patients with CNS and/or bone metastases had intermediate values. The sensitivity to detect leptomeningeal disease was 91% and 69% for brain metastases. Q CEA/Q IgA and CEA synthesis assessed with the IgA diagram were equally sensitive. CONCLUSIONS: Evaluation of CEA in the IgA diagram is feasible and of clinical value. The consideration of intrathecal CEA synthesis correlates better with the clinical status than absolute CSF-CEA or the correlation with albumin.
Authors: H Tumani; H F Petereit; A Gerritzen; C C Gross; A Huss; S Isenmann; S Jesse; M Khalil; P Lewczuk; J Lewerenz; F Leypoldt; N Melzer; S G Meuth; M Otto; K Ruprecht; E Sindern; A Spreer; M Stangel; H Strik; M Uhr; J Vogelgsang; K-P Wandinger; T Weber; M Wick; B Wildemann; J Wiltfang; D Woitalla; I Zerr; T Zimmermann Journal: Neurol Res Pract Date: 2020-03-16