Carcinoembryonic antigen (CEA) in normal and pre-eclamptic pregnancies (values in maternal blood, amniotic fluid and umbilical cord blood)

Tumor Markers In Biological Fluids Associated With Pregnancy

Proteins that are expressed by both malignant and healthy fetal tissues are recognized as oncofetal. These antigens are associated with cell proliferation and differentiation and are produced in high concentrations in pregnancy and malignancy. Their biological role in malignancy is the suppression of the host's immune system, while in pregnancy they affect the maternal immune response, generating maternal tolerance toward the embryo. This review describes the levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125), squamous cell carcinoma antigen (SCC), cancer antigen 15-3 (CA 15-3), mucin-like carcinoma-associated antigen (MCA), tissue polypeptide-specific antigen (TPS), carbohydrate antigen 19-9 (CA 19-9), and prostate-specific antigen (PSA) in maternal serum (MS), umbilical cord serum (UC), and amniotic fluid (AF) and outlines their roles in the assessment of pregnancy and malignancy. All antigens studied, except CA 15-3, are oncofetal. The presence of considerable concentrations of AFP, hCG, CEA, CA125, SCC, MCA, TPS, CA 19-9, and PSA in AF during pregnancy may be attributed to their involvement in biological functions associated with fetal development, differentiation, and maturation. MS CEA, CA 15-3, and CA 19-9, in contrast to all the others, are not influenced significantly by pregnancy and thus remain reliable tumor markers in monitoring malignancy in pregnant patients.

Carcinoembryonic antigen in high risk pregnancies

The significance of carcinoembryonic antigen (CEA) measurement was evaluated in 25 pregnant women with diabetes mellitus, 15 Rh negative sensitized and nine prolonged pregnancies. Another 114 women with normal pregnancy served as controls. Values in maternal and umbilical cord serum and in amniotic fluid did not change appreciably through 24-42 weeks' gestation. No significant difference in maternal serum, cord serum and amniotic fluid CEA values was found between diabetic, Rh negative sensitized and normal pregnancies at the corresponding weeks. Similar findings were obtained in prolonged pregnancies, except the values in amniotic fluid which were significantly higher than in normal pregnancies due to the presence of meconium. These results suggest that the measurement of CEA in high risk pregnancies is not useful in predicting fetal condition.