The clinical significances of carcinoembryonic proteins in patients with ovarian carcinoma.

Carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), placental alkaline phosphatase (ALP4), human chorionic gonadotropin (HCG), human chorionic gonadotropin-beta-subunit (beta-HCG) and human placental lactogen (HPL) were simultaneously and serially determined in the sera of the patients with ovarian carcinoma. The incidence of patients whose tests for carcinoembryonic proteins were positive was as follows: CEA, 29/55 (56.4%); AFP, 7/58 (13.5%); ALP4, 3/47 (6.4%); HCG, 20/50 (40%); beta-HCG, 13/50 (26%); HPL, 0. Determination of CEA in serum was considered to be a useful test for screening ovarian carcinoma and for follow-up studies, especially for so-called mucin-producing tumors (mucinous cystadenocarcinoma, Krukenberg's tumor, and pseudomyxoma peritonei). The specificity of AFP to ovarian carcinoma, especially in tumors of germ cell origin, seemed to be very high, thus AFP can be an extremely effective means for the diagnosis and the prognosis of patients with ovarian tumors arising from germ cells. But pure dysgerminoma, which was not positive in AFP, showed relatively high levels beta-HCG preoperatively, and its clinical course was associated with serial beta-HCG assay. There was no tumor specificity in positive HCG. ALP4 seemed to have little clinical significance because the detection was infrequent.