Improved indirect and direct radioimmunoassay for carcinoembryonic antigen.

Values obtained by the indirect and the direct assays for carcinoembryonic antigen by use of the "CEA Roche" method and reagents differ significantly. In 32 samples the latter method gave values almost twofold those obtained by the former. The mean ratio for direct/indirect was 1.9 +/- 0.6. Analytical recovery experiments on samples to which known amounts of the antigen had been added showed a similar disparity. A simple modification of these two procedures, involving addition of normal human plasma (containing less than 2.0 microgram of the antigen per liter) to standards, eliminated this discrepancy. In the indirect method, standards were added to normal human plasma, then extracted with perchloric acid before assay. In the direct assay normal human plasma instead of goat serum, was added to standards. With these modifications the analytical recoveries of added CEA by the indirect and direct methods were 87 +/- 17% and 99.7 +/- 8%, respectively, and the mean ratio between two methods was 1.2 +/- 0.4.