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HelpEpic Code LAB848 Carcinoembryonic Antigen (CEA), Spinal Fluid
Additional Codes
Mayo Code: CEASF
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Detecting meningeal carcinomatosis and intradural or extradural infiltration
Differentiating brain parenchymal metastasis from adenocarcinoma or squamous-cell carcinoma
Specimen Type
CSFLab Central Staff: All CSF specimens to Hematology first.
Specimen Required
Collection Container/Tube: Sterile vial
Submission Container/Tube: 13 x 75-mm tube
Specimen Volume: 0.5 mL
Specimen Minimum Volume
0.4 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| CSF | Refrigerated (preferred) | 14 days | |
| Frozen | 90 days | ||
| Ambient | 7 days |
Reject Due To
No specimen should be rejectedDay(s) Performed
Monday through Saturday
Reference Values
<0.6 ng/mL
Tumor markers are not specific for malignancy, and values may vary by method.
Clinical Information
Carcinoembryonic antigen (CEA) normally is present in cerebrospinal fluid (CSF) in very low concentrations. Elevations in serum CEA can cause passive transfer to CSF. Tumors of the brain, especially metastatic tumors, can elevate CSF CEA.
Cautions
Although the assay appears to be specific for adenocarcinoma and squamous cell carcinoma, increased carcinoembryonic antigen (CEA) values in cerebrospinal fluid (CSF) are not seen in all patients with such tumors of the brain.
Mildly elevated CEA values in CSF may be secondary to passive transfer from the serum in individuals with high serum CEA concentrations.
In rare cases, some individuals can develop antibodies to mouse or other animal antibodies (often referred to as human anti-mouse antibodies [HAMA] or heterophile antibodies), which may cause interference in some immunoassays. Caution should be used in interpretation of results and the laboratory should be alerted if the result does not correlate with the clinical presentation.
Interpretation
Increased values are seen in approximately 60% of patients with meningeal carcinomatosis.
Reporting Name
Carcinoembryonic Ag (CEA), CSFMethod Name
Immunoenzymatic Assay
Method Description
The Access carcinoembryonic antigen (CEA) assay is a 2-site immunoenzymatic sandwich assay using 2 mouse monoclonal anti-CEA antibodies (MAb) that react with different epitopes of CEA. A sample is added to a reaction vessel, along with the first anti-CEA MAb-alkaline phosphatase conjugate and the second anti-CEA MAb bound to paramagnetic particles. The incubation is followed by a magnetic separation and washing. The chemiluminescent substrate Lumi-Phos 530 is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is proportional to the concentration of CEA in the sample. The amount of analyte in the sample is determined by means of a stored, multipoint calibrator curve.(Package insert: Access CEA, Beckman Coulter Inc; 2020)
CPT Code Information
82378
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CEASF | Carcinoembryonic Ag (CEA), CSF | 2037-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CEASF | Carcinoembryonic Ag (CEA), CSF | 2037-0 |
Report Available
1 to 3 daysTest Classification
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.Clinical Reference
1. Klee GG, Tallman RD, Goellner JR, Yanagihara T: Elevation of carcinoembryonic antigen in cerebrospinal fluid among patients with meningeal carcinomatosis. Mayo Clin Proc. 1986 Jan;61(1):9-13
2. Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Tangen C: An evaluation of the carcinoembryonic antigen (CEA) test for monitoring patients with resected colon cancer. JAMA. 1993 Aug 25;270(8):943-947
3. Duffy MJ: Carcinogenic antigen as a marker for colorectal cancer: is it clinically useful? Clin Chem. 2001 Apr;47(4):624-630
4. Block DR, Algeciras-Schimnich A: Body fluid analysis: clinical utility and applicability of published studies to guide interpretation of today's laboratory testing in serous fluids. Crit Rev Clin Lab Sci. 2013 Jul-Oct;5(4-5):107-124
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.