In order to evaluate the significance of tissue-CEA content determination in colorectal adenomas, a study on 82 endoscopically removed adenomas from 70 patients has been carried out. The grade of dysplasia, size, and tissue-CEA content of adenomas were evaluated. Tissue-CEA was determined by an immunoperoxidase technique (PAP). High tissue-CEA content was found in polyps with moderate or severe dysplasia (χ2 = 51.7; p < 0.001), and polyps greater than 20 mm (χ2 = 9.7; p < 0.001). The relationship between severity of dysplasia and tissue-CEA distribution showed that the more widespread is marker's distribution and the more severe is the grade of dysplasia (χ2 = 70.2; p < 0.001). Finally, the follow-up of patients who underwent endoscopic polypectomy showed a higher incidence of metachronous adenomas in patients in which adenomas presenting high tissue-CEA content were removed. On the basis of these results the authors suggest that tissue-CEA determination, related to grade of dysplasia, size and number of adenomas, may be considered as a useful parameter to evaluate the cancer risk of colo-rectal adenomas and to plan closer endoscopic follow-up in these patients.