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Abstract

Colorectal cancer is a major public health problem and the majority of deaths associated with the disease are the result of metastatic spread to the liver. The biology of colorectal cancer metastasis is slowly being unraveled and involves multiple mechanisms that provide the cancer cell with an advantage for invasion, survival in the circulation and for implantation and growth in the liver. A glycoprotein tumor product that seems to offer an advantage in all these areas is carcinoembryonic antigen (CEA, CEACAM5, CD66e). While the function of CEA in normal tissues is still a subject of speculation, CEA seems to play a critical role in cancer and is involved in multiple mechanisms that are designed to provide the cancer cell with an advantage to invade and metastasize. These mechanisms include induction of changes in the tumor microenvironment at both the primary and distant metastatic site, protection against both apoptosis and cytotoxicity and implementation of angiogenisis. Thus, this review is focused on the role of CEA in promoting colorectal cancer progression and metastasis especially to the liver.

Keywords: carcinoembryonic antigen; liver metastasis, colorectal cancer, anoikis, angiogenesis, cytokines