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What Are The Factors That Affect CEA Test Results L In A Stage 3B Colon Cancer Patient?

Posted on Tue, 11 Jan 2022

Question: Hi there. I am 42 male with stage 3b colon cancer. Mildly Differentiated, and had 3 positive nodes out of 66 gathered. Clean margins. Because this was an emergency surgery, no preop cea was taken. But about five days after it was with a value of 1.0. This was back in October of 2017.
Last week i had another cea test done, first since October and it was 3.4. However i also have cystic fibrosis and was in hospital at the time with pneumonia, colitis, gastritis and a wbc of 16400. My lungs hurt to breathe as they were swollen. I had also colon wall thickening, gall bladder thickening, and bladder thickening related to my cf and colitis.
Two weeks ago i had a ct scan and it came back clear. Due to the cea should i retake it? Cant the other problems i have increase my cea? Should i be less concerned because my cea only went upby a little over two points as opposed to others who can jump 10 or more?
I have read mixed reviews of cea by different doctors in terms of how really reliable it is as it has a high degree of false alarms.
I have lost 30 pounds since my cancer dx and my cystic fibrosis has gotten worse since my cancer dx. I just wonder if all of this can explain my two point rise in cea or if i should be very worried right now. Thoughts?

Answered by Dr. Monish De (1 hour later)

Brief Answer:
CEA test after 3 months

Detailed Answer:
Hi

After hearing your history I think you do not need to worry now as your CEA level now is 3.4 ng/ml and sometimes CEA level may give false positive result as in inflammatory bowel disease and infection as you are having

When CEA level becomes 10 ng/ml or more there is a chance that recurrence of colon cancer has happened.

There is nothing to we now and I will advise you to repeat the blood for CEA test after 3 months

Regards
Dr Monish De
Oncologist

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Monish De (14 hours later)

Could the inflammation caused by my cystic fibrosis and pneumonia lead to an increase in cea levels? I had pneumonia when the cea was taken and my lungs were hurting as it was painful to take a deep breath or cough due to that lung swelling.

Answered by Dr. Monish De (9 minutes later)

Brief Answer:

Any inflammation or infection can cause rise in CEA level

Detailed Answer:

Hi

Any inflammation or infection such as pneumonia can lead to rise in CEA giving false positive result.

That is why you should follow every 3 months with fresh CEA test to see the trend and whether it is increasing or not.

Regards
Dr Monish De
Oncologist

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Monish De (9 hours later)

I have another follow up: First I was wondering what the half life of the cea is. There seems to be a good deal of fluctuations from what i have read
Second, i just found out that the cea score back in October 2017 that the lab used a different assay method as well as a different device to perform the test on compared to the different lab used last week. I read a study online that was done where it said not to compare tests that use different methods due to statistically significant difference in scores.

So i was wondering your thoughts on what is the cea half life and your thoughts on different labs using different method assays.

Answered by Dr. Monish De (4 hours later)

Brief Answer:

CEA-RIAKIT method assay and CEA-Roche assays vary differently

Detailed Answer:

Hi

CEA has a half life of up to 14 days.

CEA determination by the CEA-RIAKIT assay and CEA-Roche assay vary differently

The normal levels for CEA-RIAKIT aassay is 2.3 microgram/1

CEA-RIAKIT assay is 3.3 microgram/1,

Both methods measured CEA concentrations down to 1 microgram/1.

The ability of the two assays to discriminate between positive and negative values in patients with urogenital and gastrointestinal cancer was similar.

The response to recurrences of colorectal carcinoma was also similar and the CEA fluctuation was parallel after surgery.

The CEA Roche assay generally showed good correlation between measured and theoretical values at both low and high levels.

The CEA-RIAKIT measured too low values as compared to both the CEA-Roche and the theoretical values.

The explanation seems to be that the anti-CEA sera used in this assay show a lower affinity for plasma CEA than for tumour-extracted CEA.

Regards
Dr Monish De
Oncologist

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Monish De (16 hours later)

I just found out on a previous CT scan it showed a 1.4 cm Choledochocele Cyst in my Common Bile Duct.
Can this type of cyst cause my ALP liver enzymes to go up and fluctuate? Is it possible that it can also affect CEA levels?
And how good is a CT scan at determining the difference between a cyst and cancer?

Thanks.

Answered by Dr. Monish De (7 hours later)

Brief Answer:

CT scan is very good determining difference between cyst and cancer

Detailed Answer:

Hi

Choledochocele cyst in common bile duct may cause liver enzyme to go up but it has no relation with CEA

CT scan is very good determining difference between cyst and cancer.

It has accuracy rate of 85% to 95%.

It is far better than MRI in detecting cancer.

Regards
Dr Monish De
Oncologist

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D