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Annals of Clinical & Laboratory Science 33:32-38 (2003)
© 2003 Association of Clinical Scientists

Gastrointestinal Tract Cancer Screening Using Fecal Carcinoembryonic Antigen

Yonggoo Kim1, Seong Lee2, Seungcheol Park2, Haemyung Jeon2, Wonbae Lee3, Jae Kwang Kim4, Myungok Cho1, Myungshin Kim1, Jihyang Lim1, Chang Suk Kang1 and Kyungja Han1
1 Departments of Clinical Pathology, 2 Surgery, 3 Pediatrics, and 4 Internal Medicine, Catholic University Medical College, Seoul, Korea

Address correspondence to Kyungja Han, M.D., Department of Clinical Pathology, Catholic University Medical College, St. Mary’s Hospital, Youngdeungpo-gu, Youido-dong 62, Seoul, Korea (south) 150-713; tel 822 3779 1297; fax 822 783 6648; e-mail: hankja{at}catholic.ac.kr.

There is a great need to detect gastrointestinal tract cancer at an early stage. It is well known that most carcinoma tissues of the gastrointestinal tract contain carcinoembryonic antigen (CEA). Stools are a rich source of cells derived from the gastrointestinal tract. We analyzed total fecal CEA in 60 gastrointestinal tract cancer patients, 20 benign gastrointestinal tract disorder patients, and 240 normal controls, using a simple, reliable method. We compared the sensitivity and specificity of fecal CEA with those of serum CEA and fecal occult blood test (FOBT). The level of fecal CEA in gastrointestinal tract cancer was much higher than controls (44.1 ± 70.1 ng/mg stool vs 3.7 ± 3.5 ng/mg stool, p <0.001) and was not increased in benign gastrointestinal disorders (4.5 ± 8.2 ng/mg stool). Fecal CEA level was >10 ng/mg stool in 22 of 32 samples (69%)from stomach cancer patients and 24 of 28 samples (86%)from colorectal cancer patients. The sensitivity of serum CEA (>5 ng/ml) was 19% in stomach cancer and 39% in colorectal cancer, whereas the sensitivity of FOBT was 13% in stomach cancer and 21% in colorectal cancer. The specificity of fecal CEA was 90% in benign gastrointestinal tract disorders and 93% in normal controls. This specificity was similar to those of serum CEA and FOBT. In conclusion, fecal CEA measurement is superior to serum CEA or FOBT for detection of gastrointestinal tract cancer. Fecal CEA may become the screening test of choice for gastrointestinal tract cancer.

Keywords: gastric cancer, colorectal cancer, carcinoembryonic antigen, fecal analysis, fecal occult blood






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