A Monoclonal Antibody Quantitative Measurement And Immunohistochemical Localisation Of Carcinoembryonic Antigen In Ovarian Neoplasia

摘要

Objective: To evaluate the significance of including CEA in serum and tissues in the management protocol of patients with ovarian malignancies. Patients And Methods: The study included 68 patients which was divided into three groups. Group [A] included 21 patients with malignant ovarian tumors. Group included three patients with boderline ovarian tumors. Group [C] included eight patients with benign ovarian tumors, Group [D] included 36 women without any apparent gynaecologic disorder ( control group). Serum level of CEA was measured in all patients in group A, B and C prior to treatment and at least 12 weeks following therapy. Formalin - fixed and paraffin - embedded tissue blocks taken from 2 different sites of the studied lesions were prepared. Immunohistochemical staining for CEA was performed for the studied tissues. Results: All the ovarian tumors investigated in this work were of epithelial origin. All benign and borderline ovarian tumors had negative pre- and post-treatment serum CEA levels (< 5ng/ml) and were negative for CEA tissue stain.85.71% of ovarian serous cystadenocarcinomas had negative pre-treatment serum levels . All the squamous cell carcinomas and 66.67% of each of mucinous cystadenocarcinomas and undifferentiated carcinomas had positive (>=5ng/ml) pre-treatment serum levels. After treatment the different histological types of ovarian carcinimas were seronegative for CEA.The highest percentage of positive staining (100%) was found in squamous cell carcinomas [50% (+1) and 50% (+3)], followed by 66.67% of mucinous cystadenocarcinomasThe mean difference between pre-and post-treatment serum CEA was significant in mucinous cystadinocarcinoma with negative and positive tissue reaction and in negatively stained serous cystadinomacarcinoma.The percentages of cases of ovarian carcinomas with positive pre-treatment serum CEA increased with the increase of grade of malignancy from 33.33% in G1 to 55.56% in G II and 66.67% in GIII.No definite relation could be detected between the grade of malignancy and the intensity (degree) of reaction of malignant ovarian tumors to CEA immunostaining.The percentage of cases with positive pre-treatment levels of serum CEA increased progressively with the advance in clinical staging. The incidence was 37.5% in stage I, 55.56% in stage II, 66.67% in stage III, and 100% in stage IV. No definite relation could be detected between the clinical stages and the degree of reaction of ovarian carcinomas to CEA tissue stain. Conclusion: This study indicated that immunohistochemical identification of CEA in tumor tissue and of monoclonal antibodies quantitative measurement of CEA in human serum is a useful adjunct in the management protocol of patients with ovarian malignancies. However further studies are required to fully ascertain the usefullness of this technique. Introduction Ovarian cancer is a serious and silent disease and has high rate of mortality among malignant gynecologic tumor. It is typically diagnosed at an advanced stage(1,2,3). Furthermore, even when small ovarian tumors are considered to be resected , there is a recurrence in at least one-third of the patients(2,3,4,5). Unfortunately, despite advances in surgical technique and novel chemotherapeutic agents, survival rates have not improved significantly over past 25 years(2,6).The oncofoetal antigens comprise one particular group of markers produced by human neoplasms, these antigens have been detected in the sera of patients with gynaecological cancer. The practical use of such markers in the diagnosis and follow-up has been limited by the low sensitivity and specificity of their tests (6)..Carcinoembryonic antigen (CEA) is one of the first known tumor markers. Since then, many more have been described, but CEA, determined alone or in combination with others, is still one of the most used. CEA is not organ specific and abnormal values may be found in a wide range of carcinomas (7). Epithelial ovarian cancer is known to pr