Rule A H, Goleski-Reilly C, Sachar D B, Vandevoorde J, Janowitz H D
Gut. 1973 Nov;14(11):880-4. doi: 10.1136/gut.14.11.880.
Plasma levels of circulating carcinoembryonic antigen (CEA) were measured by zirconyl phosphate gel radioimmunoassay in 112 patients with chronic inflammatory bowel disease. The levels were then related to category, extent, duration, and severity of disease, as well as to the ages and surgical status of the patients. The distribution of CEA levels and their mean values were significantly raised over the levels in 33 normal control subjects, and were similar among patients with ulcerative colitis compared with those with granulomatous bowel disease. Positive values were defined as those in excess of 2.5 ng/ml. Positive assays occurred in 42% of ulcerative colitis patients, in 38% of Crohn's disease patients, and in 40% of the total group with inflammatory bowel disease. Among normal control subjects, only 3% were positive. Among inflammatory bowel disease patients, positive CEA assays occurred more frequently with more severe disease, more extensive anatomical involvement, younger ages, and shorter duration of disease. Those patients who had undergone total colectomy showed levels of circulating CEA and frequency of CEA positivity similar to those of an age-matched normal control group. Levels of CEA did not correspond with known cancer risk factors in patients with inflammatory bowel disease. Although rising or persisting plasma CEA values unrelated to severity and extent of disease may indicate an unfavourable prognosis in cancer, this study shows that a single CEA value in patients with chronic inflammatory bowel disease is not a reliable indicator of cancer risk.
采用磷酸氧锆凝胶放射免疫分析法对112例慢性炎症性肠病患者的循环癌胚抗原（CEA）血浆水平进行了检测。然后将这些水平与疾病的类型、范围、持续时间和严重程度，以及患者的年龄和手术状态相关联。CEA水平的分布及其平均值显著高于33名正常对照受试者的水平，且溃疡性结肠炎患者与肉芽肿性肠病患者的CEA水平相似。阳性值定义为超过2.5 ng/ml的值。42%的溃疡性结肠炎患者、38%的克罗恩病患者以及40%的炎症性肠病患者检测结果呈阳性。在正常对照受试者中，只有3%呈阳性。在炎症性肠病患者中，病情越严重、解剖学累及范围越广、年龄越小以及病程越短的患者，CEA检测呈阳性的频率越高。那些接受了全结肠切除术的患者，其循环CEA水平和CEA阳性频率与年龄匹配的正常对照组相似。CEA水平与炎症性肠病患者已知的癌症风险因素不相关。虽然与疾病严重程度和范围无关的血浆CEA值升高或持续可能表明癌症预后不良，但本研究表明，慢性炎症性肠病患者的单个CEA值并非癌症风险的可靠指标。
