Skip to main content
PMC home page
Gut logoLink to Gut
. 1989 Sep;30(9):1260–1265. doi: 10.1136/gut.30.9.1260

Comparative study of carcinoembryonic antigen and epithelial membrane antigen expression in normal colon, adenomas and adenocarcinomas of the colon and rectum.

B R Davidson 1, V R Sams 1, J Styles 1, C Dean 1, P B Boulos 1
PMCID: PMC1434233  PMID: 2806995

Abstract

The heterogeneous nature of tumour antigen expression may require selection of monoclonal antibodies on an individual patient or tumour basis to allow adequate tumour localisation. Carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) expression has not previously been compared in colorectal cancer patients. Sections of cancer (n = 52), adjacent normal colon (n = 45), synchronous adenomas (n = 11) and nodal metastases (n = 49) were examined by indirect immunoperoxidase staining in 51 consecutive patients with colorectal cancer using monoclonal antibodies to CEA and EMA. The percentage of cells with positive staining in the primary tumours was graded 1: less than 25%, 2: 25-49%, 3: 50-75%, 4 greater than 75%. All primary colorectal cancers expressed CEA and 43 of 52 expressed EMA (83%). Grading showed CEA greater than EMA in 39, equal in 11 and less in two. Well differentiated cancers were more frequently graded three or four for CEA staining (23 of 27) than moderately differentiated cancers (11 of 22) (p less than 0.01). Equivalent figures for EMA were four of 27 and three of 22 (not significant) (NS) although the majority (86%) were graded 1 and 2. Grade 1 CEA expression was found in six of 15 proximal and only two of 37 distal lesions (p less than 0.01, chi 2 test) while for EMA equivalent figures were three of 15 and six of 37 (NS). Nodal deposits all expressed CEA and 45 of 49 expressed EMA (92%); 29 of 45 normal colon sections showed CEA expression (64%) as did all adenomas. EMA was not expressed by normal colon or adenomas. These results suggest that EMA expression is more specific but less sensitive than CEA for colonic cancer and is independent of tumour differentiation and site. Thus selecting monoclonal antibodies to CEA or EMA based on tumour biopsies may allow improved tumour localisation for imaging or therapy in patents with colorectal cancer.

Full text

PDF
1260

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahnen D. J., Kinoshita K., Nakane P. K., Brown W. R. Differential expression carcinoembryonic antigen and secretory component during colonic epithelial cell differentiation and in colonic carcinomas. Gastroenterology. 1987 Dec;93(6):1330–1338. doi: 10.1016/0016-5085(87)90263-0. [DOI] [PubMed] [Google Scholar]
  2. Ballantyne K. C., Perkins A. C., Pimm M. V., Garnett M. C., Clegg J. A., Armitage N. C., Baldwin R. W., Hardcastle J. D. Biodistribution of a monoclonal antibody-methotrexate conjugate (791T/36-MTX) in patients with colorectal cancer. Int J Cancer Suppl. 1988;2:103–108. doi: 10.1002/ijc.2910410724. [DOI] [PubMed] [Google Scholar]
  3. Bordes M., Michiels R., Martin F. Detection by immunofluorescence of carcinoembryonic antigen in colonic carcinoma, other malignant or benign tumours, and non-cancerous tissues. Digestion. 1973;9(2):106–115. doi: 10.1159/000197436. [DOI] [PubMed] [Google Scholar]
  4. Casellas P., Brown J. P., Gros O., Gros P., Hellström I., Jansen F. K., Poncelet P., Roncucci R., Vidal H., Hellström K. E. Human melanoma cells can be killed in vitro by an immunotoxin specific for melanoma-associated antigen p97. Int J Cancer. 1982 Oct 15;30(4):437–443. doi: 10.1002/ijc.2910300410. [DOI] [PubMed] [Google Scholar]
  5. Chapuis P. H., Dent O. F., Fisher R., Newland R. C., Pheils M. T., Smyth E., Colquhoun K. A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer. Br J Surg. 1985 Sep;72(9):698–702. doi: 10.1002/bjs.1800720909. [DOI] [PubMed] [Google Scholar]
  6. Davidson B. R., Yiu C. Y., Styles J., Ormerod M., Clark C. G., Dean C. A comparison of carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) in human colorectal cancer. Int J Cancer Suppl. 1988;3:56–60. doi: 10.1002/ijc.2910410812. [DOI] [PubMed] [Google Scholar]
  7. Denk H., Tappeiner G., Eckerstorfer R., Holzner J. H. Carcinoembryonic antigen (CEA) in gastrointestinal and extragastrointestinal tumors and its relationship to tumor-cell differentiation. Int J Cancer. 1972 Sep 15;10(2):262–272. doi: 10.1002/ijc.2910100206. [DOI] [PubMed] [Google Scholar]
  8. Edwards P. A. Heterogeneous expression of cell-surface antigens in normal epithelia and their tumours, revealed by monoclonal antibodies. Br J Cancer. 1985 Feb;51(2):149–160. doi: 10.1038/bjc.1985.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Ellis I. O., Hinton C. P., MacNay J., Elston C. W., Robins A., Owainati A. A., Blamey R. W., Baldwin R. W., Ferry B. Immunocytochemical staining of breast carcinoma with the monoclonal antibody NCRC 11: a new prognostic indicator. Br Med J (Clin Res Ed) 1985 Mar 23;290(6472):881–883. doi: 10.1136/bmj.290.6472.881. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. GOLD P., FREEDMAN S. O. DEMONSTRATION OF TUMOR-SPECIFIC ANTIGENS IN HUMAN COLONIC CARCINOMATA BY IMMUNOLOGICAL TOLERANCE AND ABSORPTION TECHNIQUES. J Exp Med. 1965 Mar 1;121:439–462. doi: 10.1084/jem.121.3.439. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Goldenberg D. M., Sharkey R. M., Primus F. J. Carcinoembryonic antigen in histopathology: immunoperoxidase staining of conventional tissue sections. J Natl Cancer Inst. 1976 Jul;57(1):11–22. doi: 10.1093/jnci/57.1.11. [DOI] [PubMed] [Google Scholar]
  12. Granowska M., Britton K. E., Shepherd J. H., Nimmon C. C., Mather S., Ward B., Osborne R. J., Slevin M. L. A prospective study of 123I-labeled monoclonal antibody imaging in ovarian cancer. J Clin Oncol. 1986 May;4(5):730–736. doi: 10.1200/JCO.1986.4.5.730. [DOI] [PubMed] [Google Scholar]
  13. Heyderman E., Brown B. M., Richardson T. C. Epithelial markers in prostatic, bladder, and colorectal cancer: an immunoperoxidase study of epithelial membrane antigen, carcinoembryonic antigen, and prostatic acid phosphatase. J Clin Pathol. 1984 Dec;37(12):1363–1369. doi: 10.1136/jcp.37.12.1363. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Heyderman E., Steele K., Ormerod M. G. A new antigen on the epithelial membrane: its immunoperoxidase localisation in normal and neoplastic tissue. J Clin Pathol. 1979 Jan;32(1):35–39. doi: 10.1136/jcp.32.1.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Hounsell E. F., Feizi T. Gastrointestinal mucins. Structures and antigenicities of their carbohydrate chains in health and disease. Med Biol. 1982 Oct;60(5):227–236. [PubMed] [Google Scholar]
  16. Isaacson P., Le Vann H. P. The demonstration of carcinoembryonic antigen in colorectal carcinoma and colonic polyps using an immunoperoxidase technique. Cancer. 1976 Sep;38(3):1348–1356. doi: 10.1002/1097-0142(197609)38:3<1348::aid-cncr2820380339>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  17. Kalofonos H. P., Stewart S., Epenetos A. A. Antibody-guided diagnosis and therapy of malignant lesions. Int J Cancer Suppl. 1988;2:74–80. doi: 10.1002/ijc.2910410718. [DOI] [PubMed] [Google Scholar]
  18. Khoo S. K., Warner N. L., Lie J. T., Mackay I. R. Carcinoembryonic antigenic activity of tissue extracts: a quantitative study of malignant and benign neoplasms, cirrhotic liver, normal adult and fetal organs. Int J Cancer. 1973 May;11(3):681–687. doi: 10.1002/ijc.2910110319. [DOI] [PubMed] [Google Scholar]
  19. Mach J. P., Carrel S., Forni M., Ritschard J., Donath A., Alberto P. Tumor localization of radiolabeled antibodies against carcinoembryonic antigen in patients with carcinoma: a critical evaluation. N Engl J Med. 1980 Jul 3;303(1):5–10. doi: 10.1056/NEJM198007033030102. [DOI] [PubMed] [Google Scholar]
  20. Mansi J. L., Berger U., Easton D., McDonnell T., Redding W. H., Gazet J. C., McKinna A., Powles T. J., Coombes R. C. Micrometastases in bone marrow in patients with primary breast cancer: evaluation as an early predictor of bone metastases. Br Med J (Clin Res Ed) 1987 Oct 31;295(6606):1093–1096. doi: 10.1136/bmj.295.6606.1093. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Muir I. M., Ellis I. O., Bell J., Robins R. A. NCRC-11 immunoperoxidase staining patterns in breast cancer: interpretive and technical reproducibility. Histopathology. 1987 Nov;11(11):1208–1210. [PubMed] [Google Scholar]
  22. NAIRN R. C., FOTHERGILL J. E., McENTEGART M. G., PORTEOUS I. B. Gastro-intestinal-specific antigen: an immunohistological and serological study. Br Med J. 1962 Jun 30;1(5295):1788–1790. doi: 10.1136/bmj.1.5295.1788. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Payne J. E., Chapuis P. H., Pheils M. T. Surgery for large bowel cancer in people aged 75 years and older. Dis Colon Rectum. 1986 Nov;29(11):733–737. doi: 10.1007/BF02555321. [DOI] [PubMed] [Google Scholar]
  24. Pinkus G. S., Kurtin P. J. Epithelial membrane antigen--a diagnostic discriminant in surgical pathology: immunohistochemical profile in epithelial, mesenchymal, and hematopoietic neoplasms using paraffin sections and monoclonal antibodies. Hum Pathol. 1985 Sep;16(9):929–940. doi: 10.1016/s0046-8177(85)80132-5. [DOI] [PubMed] [Google Scholar]
  25. Rainsbury R. M. The localization of human breast carcinomas by radiolabelled monoclonal antibodies. Br J Surg. 1984 Oct;71(10):805–812. doi: 10.1002/bjs.1800711023. [DOI] [PubMed] [Google Scholar]
  26. Rogers G. T., Searle F., Bagshawe K. D. Carcinoembryonic antigen: isolation of a sub-fraction with high specific activity. Br J Cancer. 1976 Apr;33(4):357–362. doi: 10.1038/bjc.1976.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Rognum T., Elgjo K., Brandtzaeg P., Orjasaeter H., Bergan A. Plasma carcinoembryonic antigen concentrations and immunohistochemical patterns of epithelial marker antigens in patients with large bowel carcinoma. J Clin Pathol. 1982 Sep;35(9):922–933. doi: 10.1136/jcp.35.9.922. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Sloane J. P., Ormerod M. G. Distribution of epithelial membrane antigen in normal and neoplastic tissues and it value in diagnostic tumor pathology. Cancer. 1981 Apr 1;47(7):1786–1795. doi: 10.1002/1097-0142(19810401)47:7<1786::aid-cncr2820470711>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES