S. Ando et al., Optimal combination of seven tumour markers in prediction of advanced stage at first examination of patients with non-small cell lung cancer, ANTICANC R, 21(4B), 2001, pp. 3085-3092
Between January 1996 and December 1999, we examined seven tumour markers (c
arcinoembryonic antigen (CEA), alpha feto protein (AFP), cancer antigen CA1
9-9 (CA19-9), squamous cell carcinoma antigen (SCC), neuron-specific enolas
e (NSE), cancer antigen CA125 (CA125), cytokeratin 19 fragment (CYFRA)) in
312 patients (200 patients with adenocarcinoma (Ad); 112 patients with squa
mous cell carcinoma (Sq)). In Ad patients, CEA showed the highest positivit
y rate (46.5% of Ad patients) Which rose as the stage advanced and was foll
owed by CA125, the positivity rate of which also increased with the stage.
All the Ad cases (35 out of 35:100%) with CA125 levels above 70 ng/ml were
advanced (stage IIIB or IV), regardless of the other tumour markers. In Sq
patients, the positivity rate of CYFRA (48.2%) was the second highest behin
d SCC (55.4%), but increased as the stage advanced. As regards the combinat
ions of two markers, in Ad patients, both CYFRA and CA125 showed significan
t supplementary value when used with CEA, even though CF-A expression was a
bsent. Furthermore, most of the CEA, CYFRA (25 out of 26:96.2%) and CEA, CA
125 (38 out of 40:95.0%) double-positive Ad patients were also in the advan
ced stage. In Sq patients, no additional sensitivity and specificity in the
prediction of advanced stage resulted from any combination of CYFRA with o
ther markers. By selecting appropriate tumour markers in NSCLC patients, we
can predict the stage of the lung cancer and utilize these markers as comp
lementary tools to establish indications for treatment.