Alpha-fetoprotein and carcinoembryonic antigen in pancreatobiliary disease with and without jaundice.

A comparative study of alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in serum was made by radioimmunoassay in 66 patients with pancreatobiliary disease with and without obstructive jaundice. biliary concentrations of these proteins were assayed in 12 patients with benign and 7 patients with malignant disease. There was no statistical difference in serum AFP between these two groups but there was a difference in serum CEA. Although CEA and AFP in bile in both groups were higher than in serum there was no statistical difference in serum CEA and AFP in patients with and without obstructive jaundice in either benign or malignant disease. In benign disease, patients with inflammation had higher serum CEA than normal. Although there was no statistical difference in serum CEA in patients with a without liver metastases, the serum CEA in liver metastases was significantly higher than in benign disease. We concluded that AFP is unlikely to be important in the assessment or management of patients with cancers other than those derived from the liver or yolk sac, and that the elevation of serum CEA in patients with malignant pancreatobiliary disease either with or without obstructive jaundice occurs mainly in the presence of widespread malignancy, especially in liver metastases.