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. 2024 Apr 2;5(6):585-592.
doi: 10.1002/bco2.354. eCollection 2024 Jun.

CEA (CEACAM5) expression is common in muscle-invasive urothelial carcinoma of the bladder but unrelated to the disease course

Affiliations

CEA (CEACAM5) expression is common in muscle-invasive urothelial carcinoma of the bladder but unrelated to the disease course

Henning Plage et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Objectives: Carcinoembryonic antigen (CEA) is a cell surface glycoprotein that represents a promising therapeutic target. Serum measurement of shedded CEA can be utilized for monitoring of cancer patients.

Material and methods: To evaluate the potential clinical significance of CEA expression in urothelial bladder neoplasms, CEA was analysed by immunohistochemistry in more than 2500 urothelial bladder carcinomas in a tissue microarray format.

Results: CEA staining was largely absent in normal urothelial cells but was observed in 30.4% of urothelial bladder carcinomas including 406 (16.7%) with weak, 140 (5.8%) with moderate, and 192 (7.9%) with strong staining. CEA positivity occurred in 10.9% of 411 pTaG2 low-grade, 32.0% of 178 pTaG2 high-grade, and 43.0% of 93 pTaG3 tumours (p < 0.0001). In 1335 pT2-4 carcinomas, CEA positivity (34.1%) was lower than in pTaG3 tumours. Within pT2-4 carcinomas, CEA staining was unrelated to pT, pN, grade, L-status, V-status, overall survival, recurrence free survival, and cancer specific survival (p > 0.25).

Conclusion: CEA increases markedly with grade progression in pTa tumours, and expression occurs in a significant fraction of pT2-4 urothelial bladder carcinomas. The high rate of CEA positivity in pT2-4 carcinomas offers the opportunity of using CEA serum measurement for monitoring the clinical course of these cancers. Moreover, CEA positive urothelial carcinomas are candidates for a treatment by targeted anti-CEA drugs.

Keywords: CEA; CEACAM5; bladder cancer; immunohistochemistry; prognosis; tissue microarray.

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Conflict of interest statement

The rabbit recombinant CEA antibody, clone MSVA‐465R was obtained from MS Validated Antibodies GmbH, Hamburg, Germany (owned by a family member of GS).

Figures

FIGURE 1
FIGURE 1
CEA immunostaining in normal and neoplastic urothelium. Cytoplasmic CEA staining is strong in the vast majority of tumour cells in a pTa tumour (A) and a muscle‐invasive urothelial carcinoma (B) while the CEA staining only involves a smaller subset of tumour cells in another pT2 carcinoma (C). CEA staining is absent in normal urothelium (D) as well as in other examples of pTa (E) and muscle‐invasive urothelial carcinomas of the urinary bladder (F).
FIGURE 2
FIGURE 2
CEA immunostaining and patient prognosis. (A) Overall survival, (B) cancer‐specific survival, and (C) recurrence‐free survival.

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