Endocrine Abstracts

Background: The importance of carcinoembryonic antigen (CEA) assessment in the evaluation of medullary thyroid carcinoma is well known. The role of CEA in the assessment of other neuroendocrine tumors (NET) is not clear. We aimed to evaluate a possible correlation between CEA measurements and the aggressivity of NETs.

Methods: We evaluated 56 (36 women) NETs followed in a tertiary center (23 gastrointestinal, 12 pancreatic, 10 pulmonary, 7 without primary tumor localization, 1 urinary bladder and 3 neuroendocrine carcinomas (NEC)). We evaluated a possible correlation with the CEA measurements (absolute values and dichotomic values, larger than the upper normal cutoff value, UNV) and ki67% values, type of NET, the presence of metastases, hepatic or all other types and newly imagistic evaluation suggestive of progressive metastatic disease. All CEA measurements were done using the same technique. Patients with medullary thyroid carcinoma were excluded.

Results: Three patients (5.35%) had values 10 times higher than the UNV, 23 patients (41%) had levels above UNV. Ki67% values were available only for 45 patients, no correlation was found between ki67% and CEA values, correlation coefficient -0.03, P=0.07. Also, we didn’t find a correlation between abnormal CEA values and the presence of metastatic disease other than hepatic (23 patients), hepatic metastasis (18 patients), gastrointestinal type of NET and newly diagnosed progressive disease (13 patients), with correlation coefficients between 0.13-0.2, p>0.05. The newly diagnosed progressive disease was mainly observed on hepatic metastases. Thirty-eight patients were currently on somatostatin analog (SSA) treatment, no correlation being found between CEA values and the presence SSA treatment (0.12, P=0.36).

Conclusion: Data presented does not support a role of CEA in the algorithm assessment of NETs. In the same time, a large number of patients had abnormal values, raising the question of a possible importance of CEA evaluations in this patients, further studies with higher number of patients and correlation with other neuroendocrine markers are warranted.