Frederic P. Herter

Tumor-associated antigen in patients with carcinoma of the colon

In 1965 Gold and Freedman [1,2] described an antigen isolated from saline extracts of colonic adenocarcinema. They called this antigen carcinoembryonic antigen (CEA) because of its distribution in neoplastic tissue of gastrointestinal origin and in the embryonic gastrointestinal tract. It was characterized by Krupey, Gold, and Freedman [3] as a protein polysaccharide complex soluble in 1.0 M perchloric acid (PCA) and 50 per cent saturated ammonium sulfate, and they have also reported its amino acid and carbohydrate composition. A radioimmunoassay procedure has been developed by Thomson et al [5] to detect and measure circulating antigen in the serum of patients. They demonstrated circulating CEA in a high percentage of patients with primary gastrointestinal neoplasms but they could not detect this antigen in patients with other types of primary neoplasms [5]. An antigen thought to be identical to CEA has been reported by Von Kleist and Burtin [4]. Serologic studies by Gold demonstrated antibodies to CEA in pregnant women and in a high percentage of patients with digestive system neoplasms both with and without metastases. For the past three years we have been attempting, in our laboratory, to further define the nature and significance of CEA as defined by Gold and Freedman [1,2]. Using both their reagents and methods and

Carcinoembryonic antigen and prognosis in patients with colon cancer.

One-hundred and fifty patients with non-metastatic colo-rectal cancer were followed for a period of 24 to 36 months postoperatively. Preoperative CEA values have been shown to correlate with the extent of the disease and the patients prognosis. The prognosis for recurrences is greater in patients with elevated pre-operative CEA values regardless of the stage of their disease. This tendency to have recurrences is 1.8 times higher in individuals with increased pre-operative CEA levels. This same relationship occurs to a greater or lesser extent at each stage of the disease.

Preparation of the bowel for surgery.

Controversy continues to exist in this important area because no large scale randomized prospective clinical study comparing antibiotic preparation of the bowel with mechanical preparation alone has ever been completed. A regimen for mechanical cleansing of the bowel is suggested, and arguments for and against the use of intestinal antibiotics are presented, relating particularly to superinfection, suture line recurrence, and possible changes in host resistance to infection.

Immunologic Tests for the Detection of Gastrointestinal Cancers

The fact that fetal proteins can be produced by cancerous tissue provides a new tool for the early diagnosis and possibly immunotherapy of cancer. The four tests described hold promise of clinical usefulness in the near future for the detection and diagnosis of gastrointestinal tumors.

Studies on tumor-associated antigen: TAA

Abstract A method for the preparation of tumor-associated antigen (TAA) is described. We have been able to demonstrate two antigens with common antigenic determinants that are separable by ion-exchange chromatography and electrophoresis. These antigens appear identical by Ouchterlony immuno-diffusion analysis and by Sephadex chromatography. The differences in electrophoretic mobility of these antigens appear related to a sialic acid moiety, although we have demonstrated that the antigenic specificity does not reside in this portion of the molecule. These antigens share at least one common determinant with a low-molecular-weight substance found in perchloric acid extracts of normal lung and colon. This and previous studies would suggest that this antigen is identical to carcinoembryonic antigen (CEA).

Comparison of Lymphocyte Reactivity in Patients with Cancer, Systemic Lupus Erythematosus and Renal Allografts

The PHA and MLC reactivity of lymphocytes from patients with cancer, SLE or renal allografts was comparatively tested in the presence of autologous and of normal homologous serum. Sera from patients with advanced cancer, active SLE or chronic allograft rejection strongly inhibited the MLC reactivity of autologous lymphocytes. It is suggested that serum inhibitory factors might be antibodies which are directed against modified antigenic determinants of the major histocompatibility complex, and are capable of blocking T lymphocyte receptors.