Carcino-embryonic antigen (CEA) in gastric adenocarcinomas. Morphologic patterns and their relationship to a histogenetic classification.

The presence of carcino-embryonic antigen (CEA) was studied in 92 consecutive cases of gastric adenocarcinoma, using the two-layer conjugated immunoperoxidase technique. Three characteristic patterns of CEA localization were identified. Type I: Intracytoplasmatic granules covering the entire cytoplasm of the malignant cells. Type II. Linear or granular deposits along the glycocalyx or in the apical cytoplasm of the malignant cells. Type III: Tumour cells negative for CEA or only showing a very weak reaction in a few cells. These CEA patterns were significantly related to the histogenetic classification of gastric adenocarcinomas proposed by Mulligan & Rember. The majority of the "mucus cell carcinomas" showed the type I CEA pattern. "Intestinal cell carcinomas" predominantly showed the type II CEA pattern and the "pyloro-cardiac gland carcinomas" the type III CEA pattern. The significance of the CEA patterns in respect of the histogenetic classification is discussed.