Immunology Introduction: After colonoscopy detected the presence of malignant tumour, LD underwent a surgery.

Three serum sample, the first one taken immediately at preoperation, one taken three weeks later at follow-up and the final one taken after eight week post-operation. Carcino-embryonic antigen or CEA is a glycoprotein which is produced during embryonic development. The production of CEA stops before birth and it usually is not present in the blood of healthy adults. Individuals with colorectal carcinoma are found to have higher level of CEA than the normal individuals.CEA concentration analysis is mainly used as a tumour marker to identify reappearance after a surgery. Elevated CEA levels should return to normal after successful surgery or within 6 weeks of starting treatment if cancer treatment is successful. It is done so by using an Enzyme-linked immunoasorbant assay (ELISA) which detects the presence of an antigen or an antibody in a sample. A quantity of CEA antigen is linked to the surface of the plate and incubated with 100ul of antibody (anti-CEA) to bind to the antigen. Antibody is connected to enzymes and in the concluding step of the analysis, a coloured substrate is added in order that the enzyme is able to emit a detectable signal. We will use the values of optical density so obtained to analyse the concentration of CEA in each sample from LD, which will help us to measure response to surgery and to monitor whether the disease has reoccurred. Aim: To quantify the concentration of CEA in three serum samples from LD that will help us to analyse whether the surgery has worked and to monitor any reoccurrence of malignant tumour in the colon. Results: 1 2 3 4 5 6 7 8 9 10 (Serum A) 11(Serum B) 12(Serum C) A (+ve control) 0.240 0.219 0.203 0.192 0.178 0.170 0.158 0.148 0.145 0.221 0.076 0.148 B(-ve control) 0.072 0.079 0.075 0.078 0.076 0.072 0.077 0.076 0.078 0.217 0.077 0.147 Positive control (40ng/mL) is needed to enable quantification of sample and is often double diluted from disease levels to normal ranges. It is needed to prove that the experiment has worked. Negative control (PBS saline) tells us what negative results look like and is required to prove the reliability of the experiment.

The following calibration graph was obtained using a positive control concentration (double diluted) and absorbance reading at 405nm.

0.3 Absorbance at 405 nm (arbitary values) 0.25 0.2 0.15 0.1 0.05 0 0 10 20 30 Concentration of +ve control (ng/mL) 40 50 60

Concentration of CEA in serum A = Concentration of CEA in serum B= Concentration of CEA in serum C= The normal reference range for CEA is 2.5ng/mL -5ng/mL. Conclusion: The decrease in CEA concentration in LD after surgery shows that the CEA-producing tumour has been removed. The serum sample taken after three weeks of surgery shows decrease in the concentration and the sample taken after eight weeks shows very little trace of CEA which verifies that the surgery has worked for LD and his treatment has been successful. Furthermore if there was steadily rising CEA level, it would occasionally be the first sign of tumour reoccurrence. Reference: 1)Benjamini,E;Sunshine,G;Leskowitz,S(1996)Immunology-A short course.Third Edition.John Wiley & Sons,Inc:United States of America. 2)Sompayrac,L.M (1999)How the Immune System works.Third Edition.Blackwell Publications:Great Britain. 3)The labtestonline website
http://www.labtestsonline.org.uk/understanding/analytes/cea/test.html (accessed on 13/12/10) 4) The webmd website http://www.webmd.com/cancer/carcinoembryonic-antigen-cea (accessed on 13/12/10)