Ultrastructural localization of carcinoembryonic antigen in normal intestine and colon cancer: abnormal distribution of CEA on the surfaces of colon cancer cells.

The distribution of carcinoembryonic antigen (CEA) in normal small intestine, normal colon, and colon cancer of humans was determined immunocytochemically by the peroxidase-labeled antibody method at the light and electron microscopic levels. In the small intestine, CEA was found in protein synthetic organelles, in the mucus, on the microvilli of goblet cells, and on some microvilli of columnar cells adjacent to goblet cells. In the normal colon, CEA was found in protein synthetic organelles of the fully differentiated columnar cells and goblet cells, as well as on the microvilli of the cells. In two well-differentiated colon cancers, the normal preferential surface expression of CEA on the microvilli was maintained, but in six poorly differentiated cancers, CEA was distributed equally over the entire cell surface. We conclude that CEA is a product of goblet cells in the small intestine, columnar and goblet cells in the colon, and colonic cancer cells. CEA on the surfaces of the normal epithelial cells is expressed in a polar manner. This polarity is lacking in undifferentiated neoplastic colon cells, which suggests that failure to establish or maintain the polar expression of normal cell-surface glycoproteins is a characteristic of the neoplastic cells.