Pinto M M, Monteferrante M, Kaye A D
Department of Cytology, Bridgeport Hospital, CT 06610.
Diagn Cytopathol. 1991;7(1):23-6. doi: 10.1002/dc.2840070108.
Carcinoembryonic antigen (CEA) was measured in 50 consecutive fine-needle aspirates of liver to determine whether elevated levels could predict the presence of carcinoma in cytologically negative aspirates. There were 44 malignant and 6 benign lesions. The highest mean CEA values (591-672 ng/ml) were obtained in metastatic adenocarcinoma of the colon, stomach, and pancreas; lower levels (13.5-151 ng/ml) were found in metastatic carcinoma from the breast and lung. Carcinoid, hepatoma, Hodgkin's disease, and benign liver aspirates had low (less than 5 ng/ml) CEA levels. Cytologic diagnosis of malignancy was 96% sensitive and 100% specific. Using 5 ng as a cutoff for malignancy, the overall sensitivity of CEA for detection of malignancy was 77%; for detection of adenocarcinoma alone, sensitivity was 85%. Specificity was 100%. The CEA content of fine-needle aspirates generally exceeded serum values by 10-100-fold. Although CEA content did not enhance the sensitivity of cytologic diagnosis, it may suggest metastatic carcinoma of the GI tract in patients presenting with adenocarcinoma of an unknown primary source.
对50例连续的肝脏细针穿刺抽吸物进行癌胚抗原（CEA）检测，以确定CEA水平升高是否能预测细胞学检查阴性的抽吸物中是否存在癌。其中有44例恶性病变和6例良性病变。结肠、胃和胰腺转移性腺癌的CEA平均水平最高（591 - 672 ng/ml）；乳腺癌和肺癌转移癌的CEA水平较低（13.5 - 151 ng/ml）。类癌、肝癌、霍奇金病以及肝脏良性抽吸物的CEA水平较低（低于5 ng/ml）。恶性病变的细胞学诊断敏感性为96%，特异性为100%。以5 ng作为恶性病变的临界值，CEA检测恶性病变的总体敏感性为77%；仅检测腺癌时，敏感性为85%。特异性为100%。细针穿刺抽吸物中的CEA含量通常比血清值高10 - 100倍。虽然CEA含量并未提高细胞学诊断的敏感性，但对于不明原发灶腺癌患者，它可能提示胃肠道转移癌。
