Loewenstein M S, Zamcheck N
Cancer. 1978 Sep;42(3 Suppl):1412-8. doi: 10.1002/1097-0142(197809)42:3+<1412::aid-cncr2820420805>3.0.co;2-8.
Elevated circulating CEA levels occur in patients with benign gastrointestinal and hepatic disorders. These are usually less than 10 ng/ml. Of clinical importance is the influence of liver disease on the interpretation of CEA. At least 50% of patients with severe benign hepatic disease have elevated CEA levels, most often active alcoholic cirrhosis, and also chronic active and viral hepatitis, and cryptogenic and biliary cirrhosis. Patients with benign extrahepatic biliary obstruction may have increased plasma CEA, the highest in patients with co-existent cholangitis and especially liver abscess. The liver appears to be essential for the metabolism and/or excretion of CEA. Hence, liver work-up is needed to assess any patient with an elevated CEA. A damaged liver may further augment elevated CEA levels due to cancer. The increased circulating CEA observed in some patients with active ulcerative colitis tends to correlate with severity and extent of disease and usually returns to normal with remission. CEA levels also may be mildly elevated in patients with pancreatitis and in adults with colonic polyps. Smoking may contribute to the increased CEA levels seen in patients with alcoholic liver disease and pancreatitis. Therefore, in interpreting mildy elevated circulating CEA levels in patients with GI tract diseases, one must consider benign as well as malignant etiologies.
良性胃肠道和肝脏疾病患者的循环癌胚抗原（CEA）水平会升高。这些水平通常低于10 ng/ml。肝脏疾病对CEA解读的影响具有临床重要性。至少50%的严重良性肝病患者CEA水平升高，最常见的是酒精性肝硬化，还有慢性活动性肝炎、病毒性肝炎、隐源性肝硬化和胆汁性肝硬化。良性肝外胆管梗阻患者的血浆CEA可能升高，在合并胆管炎尤其是肝脓肿的患者中最高。肝脏似乎对CEA的代谢和/或排泄至关重要。因此，对于任何CEA升高的患者都需要进行肝脏检查。受损的肝脏可能会进一步使癌症导致的CEA水平升高。在一些活动性溃疡性结肠炎患者中观察到的循环CEA升高往往与疾病的严重程度和范围相关，通常在缓解时恢复正常。胰腺炎患者和患有结肠息肉的成年人的CEA水平也可能轻度升高。吸烟可能导致酒精性肝病和胰腺炎患者的CEA水平升高。因此，在解读胃肠道疾病患者循环CEA水平轻度升高时，必须考虑良性和恶性病因。
