Ann Thorac Surg 2004;77:754
© 2004 The Society of Thoracic Surgeons
Correspondence
Discrepancy in serum carcinoembryonic antigen levels by measuring kits
Noriyoshi Sawabata, MD,
Masayoshi Inoue, MD,
Shin-ichi Takeda, MD,
Hajime Maeda, MD
Division of Surgery Toneyama National Hospital, 5-1-1, Toneyama, Toyonaka, Osaka 560-8552, Japan
e-mail: nsawabata{at}m5.dion.ne.jp
To the Editor:
Buccheri and Ferrigno [1] reported that preoperative carcinoembryonic antigen (CEA) levels could identify patients at risk of early postoperative recurrence of lung cancer. Preoperative serum CEA levels are also a prognostic indicator of non–small cell lung cancer. In our study [2], we used a CEA measuring kit that reacts to not only CEA but also nonspecific cross-reacting antigen-2 and normal fecal antigen-2 (IM CEA; Dynabbot, Tokyo, Japan) [3]. Because of cross-reactivity, there could be false-positive high CEA measurements. Therefore, we began a study using a CEA measuring kit that reacts only to CEA (RUMI-PULSE; Fujirebio, Tokyo, Japan).
The correlation of CEA levels between the two different kits in 85 patients with lung cancer is shown in Figure 1.
One patient had a CEA level greater than 10 µg/dL using IM CEA but less than 5 µg/dL using RUMI-PULSE. This dissociation could be due to cross-reacting antigens.
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Fig 1. Correlation of carcinoembryonic antigen (CEA) levels between two different measuring kits in 85 patients with lung cancer.
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We believe that a measuring kit that reacts only to CEA should be used in assessing CEA levels. This is because a positive serum CEA level, ie, a high level, has to be reevaluated. In the near future, CEA levels might be an indicator in some targettherapy. What was the status of the CEA measuring kit in the study by Buccheri and Ferrigno?
References
- Buccheri G., Ferrigno D. Identifying patients at risk of early postoperative recurrence of lung cancer: a new use of the old CEA test. Ann Thorac Surg 2003;75:973-980.[Abstract/Free Full Text]
- Sawabata N., Ohta M., Takeda S., et al. Serum carcinoembryonic antigen level in surgically resected clinical stage I patients with non-small cell lung cancer. Ann Thorac Surg 2002;74:174-179.[Abstract/Free Full Text]
- Kuroki M., Haruno M., Arakawa F., Wakisaka M., Matsuoka Y. Reaction profiles of seven enzyme immunoassay kits for carcinoembryonic antigen (CEA) analyzed with purified preparations of CEA and related normal antigens. Clin Biochem 1992;25:29-35.[Medline]
