Carcinoembryonic antigen in carcinoma of the uterine cervix. 1. The prognostic value of serial plasma determinations.

Plasma carcinoembryonic antigen (CEA) determinations were obtained prior to therapy in 300 patients with invasive carcinoma of the uterine cervix followed at the University of Kentucky Medical Center from 1971 to 1976. Carcinoembryonic antigen levels were elevated (greater than 2.5 ng/ml) in 48% of cervical cancer patients, and varied directly with stage of disease and histologic differentiation of the tumor. Plasma CEA levels were more commonly elevated in patients with endocervical adenocarcinoma than in those with squamous cell carcinoma, but were not related to vascular invasion in the specimen or regional lymph nodal morphology. Two hundred and four patients had 2 to 15 (mean = 5) follow-up plasma CEA determinations after treatment. Thirty patients had progressively increasing plasma CEA levels following therapy, of which 29 developed recurrent cervical cancer. A progressive rise of plasma CEA preceded the clinical diagnosis of recurrence by 1 to 23 months (mean = 6 months) in 13 of these patients, and occurred at the same time or after the clinical diagnosis of recurrence in 16 cases. Patients with progressively rising plasma CEA levels following therapy for cervical cancer should be extensively evaluated to rule out the presence of occult recurrence.