Are circulating CEA immune complexes a prognostic marker in patients with carcinoma of the gastrointestinal tract?

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Abstract
CEA [carcinoembryonic antigen] immune complexes and free CEA were determined in 363 patients with histologically confirmed adenocarcinoma of the gastrointestinal tract before surgery and in a postoperative follow-up. Circulating CEA immune complexes (CEA-IC) could be detected preoperatively in 89 patients. Incidence of CEA-IC increased with increasing tumor extension; 72/89 patients with CEA-IC showed already metastatic disease progression, 40/89 had nonresectable tumors. Patients with preoperative CEA-IC had a poorer prognosis than patients without CEA-IC but with high levels of free CEA, or CEA-negative patients. The appearance of CEA-IC with consecutive increases in the postoperative follow-up indicated disease recurrence. In 32/55 relapse cases, circulating CEA-IC were detected postoperatively, all 32 cases developing metastatic spread of disease.