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Twenty-three out of 28 patients with metastatic breast carcinoma and one out of 13 patients with localised disease had raised levels of plasma immunoreactive calcitonin. Monolayer cultures of breast carcinomas maintained for up to 10 weeks released immunoreactive calcitonin, and a primary breast carcinoma passaged in "nude" mice for over a year contained material immunologically and chromatographically resembling the monomeric form of human calcitonin. These studies indicate that breast carcinomas can produce calcitonin and that plasma calcitonin measurements may be useful in staging patients with breast carcinomas.

Serial estimations of plasma carcinoembryonic antigen (C.E.A.) levels have been carried out in 220 patients with colorectal carcinomas who had potentially and apparently curative surgery. In a two-year follow-up period 53 patients developed recurrences or metastases. In 36 of these patients sustained rises in plasma C.E.A. titres occurred synchronously with or between three and 18 months before the clinical detection of recurrences or metastases. The use of serial plasma C.E.A. assays is therefore recommended as an additional diagnostic aid for the earlier detection of recurrent or metastatic colorectal carcinomas.

Two radioimmunoassays for human lactalbumin have been established using a rabbit antiserum. One assay uses a second antibody to separate bound from free label; the other uses polyethylene glycol to precipitate gamma globulin non-specifically. We have confirmed that about half the normal human population have a substance in their blood which inhibits the binding of lactalbumin to the rabbit antibody. Comparison of the two assays has demonstrated that this material is not lactalbumin but a naturally occurring antibody. We have shown that it is in the IgG fraction of human plasma and is probably a cross-reacting antibody to bovine lactalbumin. None out of fifteen males and fourteen out of fifty eight non-pregnant, non-lactating females had low levels of lactalbumin in the their blood (0.6--2.0 ng/ml). Our assay could not detect a statistically significant difference between normal women and those with either benign breast disease or metastatic mammary carcinoma.

Increased amounts of carcinoembryonic antigen (C.E.A.) or C.E.A.-like material are found in the urine of many patients with transitional cell carcinomas of the bladder, including those presumed to be at an early stage of development. It is suggested that measurement of urinary C.E.A. is of clinical diagnostic value in the detection and follow-up of urothelial carcinomas.

Our studies have confirmed that raised plasma levels of carcinoembryonic antigen (C.E.A.) occur with many but not all malignant tumours, particularly those of the gastrointestinal tract, breast, and bronchus. However, the incidence of raised values may reach 30% in diseases associated with inflammation or regeneration or both. Consequently, it cannot serve yet as a routine screening test for cancer. Effective surgical therapy results in high plasma C.E.A. levels returning to normal. Subsequent rises appear to develop with tumour recurrence or spread. At present the most useful role for C.E.A. seems to be in monitoring patients during the post-therapeutic followup period. Further basic work is required before C.E.A. can become of routine medical value.