The Carcinoembryonic Antigen - Full Review

The Carcinoembryonic Antigen (CEA):

Past, Present, and Future*

Phil GoldÝ, C.C., O.Q., M.D., Ph.D. and Neil A. Goldenberga

* Portions of this review have been published in Perspectives in Colon and Rectal Surgery 9(2); 1996.

To whom correspondence should be addressed:

Ý Clinical Research Centre, Montreal General Hospital, McGill University, Suite D13- 173, 1650 Cedar Avenue, Montreal, QC, Canada H3G 1A4.

a Faculty of Medicine, McGill University, 3655 Drummond St., Montreal, QC, Canada H3G 1Y6

INTRODUCTION

Just as Kierkegaarde observed that, "life must be understood backward [but]...lived forward" (1), so it is with science, which must be performed forward--but may be written backward. In the telling, the phenomenon of scientific revisionism unfortunately omits much of both the humanity and the enjoyment of the scientific process. "How could they have guessed that those results would be obtained?" asks the novice. With due respect to "gut" intuition, the answer is very frequently that "they" couldn't have guessed. Yet, the most exciting science is that which leads to unexpected findings and requires the eye and mind of the iconoclast to realize that new ground has been broken.

About 30 years before the writing of this article began, the first author was given the opportunity to begin a series of experiments that would lead to the discovery of CEA as a human tumor marker, and to the myriad avenues of CEA research that are being actively pursued at the present moment. As noted above, it might be very satisfying to state that these investigations were undertaken with clear insight into the potential experimental pitfalls that might be encountered and the ultimate value of the data that would be obtained. This was not quite the case, and the problems of data interpretation, confounding semantics, and personal biases were certainly not anticipated.

In the course of the work to be described, the meaning of the Kuhnian paradigm (2) and the manner in which...