Carcinoembryonic antigen (CEA) is a glycoprotein normally produced only during early fetal life and during rapid multiplication of epithelial cells, especially those of the digestive system. Elevations of CEA occur with many cancers, primary and recurrent, as well as with a number of nonmalignant diseases and in smokers (Table 3-15). Although the test is not diagnostic for any specific disease, it is used primarily when various types of carcinomas are suspected.

• Less than 2.5 ng/mL

• Levels may be elevated in smokers who do not have malignancies.

• Monitoring of clients with inflammatory intestinal disorders with a high risk of malignancy
• Suspected carcinoma of the colon, pancreas, or lung, because these cancers produce the highest CEA levels
• Monitoring of response to therapy for cancer, with effective treatment indicated by normal levels within 4 to 6 weeks
• Monitoring for recurrence of carcinoma, with elevated levels occurring several months before the client becomes symptomatic
• Suspected leukemia, gammopathy, or other disorder associated with elevated CEA levels (see Table 3-15)

Nursing Care Before the Procedure

Client preparation is the same as that for any study involving the collection of a peripheral blood sample (see Appendix I).

A venipuncture is performed and the sample collected in a red-topped tube. The sample must be handled gently to avoid hemolysis and transported promptly to the laboratory.

Nursing Care After the Procedure

Care and assessment after the procedure are the same as for any study involving collection of a peripheral blood sample.

• Abnormal values: Note and report increased values or return of increased values. Assess history for presence of malignancy and site or treatment of malignancy. Assist client and family in coping with need for additional treatments or poor prognosis.