Gastric juice CEA levels: importance of age and gastric mucosal damage

SERUM carcinoembryonic antigen (CEA) was originally proposed as a spccific marker for colon, pancreas, lung, breast or gastric cancer [ 1-51. CEA serum levels have however been subsequently shown to bc affected by a number of factors, such as benign diseases [6,7] or by habits, like smoking or drinking, by aging or even by a poor work environment [8-111. Gastric juicc immunorcactive CEA has been found to be morc sensitive in detecting patients with gastric cancer than serum CEA [ 121. Increased lcvels of gastric juice CEA are also detectable in ‘high risk’ paticnts, such as subjects affected by moderate or severe chronic atrophic gastritis (CAG) and/or by cpithelial dysplasia. The determination may thus represent an important tool also in carly diagnosis of gastric cancer [ 131. Dr Touitou’s paper [l l] on the cumulative effects of age and pathology in determining CEA serum levcls in an unselected elderly population prompted US to invcstigate whether, in our expericncc, aging significantly affccted also gastric juice CEA lcvcls. Onc hundred and twenty-seven subjects, undergoing endoscopy because of the presencc of upper digestive tract complaints, entered the study (89 males, 38 females, mean age 48, range 19-84). For each subject, routine antral and fundic biopsies (2 + 2), together with biopsies of focal lesions, were prrformed. Thirty-eight subjects, in whom no macroscopic and no or minor microscopic alterations were documentcd, were selected as a control