Carcinoembryonic antigen (CEA) is a non-specific serum biomarker that is elevated in various malignancies such as colorectal cancer, medullary thyroid cancer, breast cancer, mucinous ovarian cancer, etc. It was first detected in colon cancer cells by Freedman and Gold and eventually was found in various other epithelial cells in the stomach, tongue, esophagus, cervix, and prostate.
It is a glycoprotein with a molecular weight of 200 kDa and is normally derived from embryonic endodermal epithelium in the fetus, controlled by fetal oncogenes. It usually disappears from serum after birth; however, small quantities of CEA may remain in colon tissue. CEA and related genes (29 of which 18 are normally expressed) constitute the CEA family in human beings and are clustered on chromosome 19q13.2.
Since it is associated with various types of malignant and nonmalignant medical conditions (Table 1), elevated serum CEA is not a definitive marker of a particular site of cancer origin. Therefore, it is not recommended for routine screening or diagnosis of cancers by itself. CEA is currently being studied as a target for various cancer-directed therapies.
Table: 1 Malignant and nonmalignant conditions associated with elevated CEA
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