Serum carcinoembryonic antigens in patients with carcinoma of the cervix.

Serum levels of carcinoembryonic antigen (CEA) were measured by a radioimmunoassay technique. The mean CEA level for 80 controls was 2.03 ng/ml with a standard deviation of 0.49 ng/ml. Hence, the upper limit of normal for serum CEA levels was considered to be 3.01 ng/ml, ie, two standard deviations above the mean. Serum CEA levels were measured in 86 patients with cervical squamous cell carcinoma, Stages 0 through IV. Thirty-five of the 74 patients with invasive cervical carcinoma were CEA-positive (serum levels above normal); patients with cervical dysplasia or carcinoma in situ were all CEA-negative. Study of the distribution of these patients together with the extent of their disease leads to the following conclusions: a) determination of serum CEA levels cannot serve as a test for the early diagnosis of cervical cancer or precancerous lesions; b) in patients with clinical Stage I or II cervical cancer, an elevated serum CEA level indicates a greater likelihood of parametrial invasion or lymph node metastasis; c) in patients with treated carcinoma of the cervix, continued normal levels of serum CEA affirm continued absence of the disease, whereas development of an elevated level is highly suspicious of occult residual or recurrent cancer. The authors urge periodic determinations of serum CEA levels in patients with treated cervical cancer.