Clinical evaluation of four tumor markers in malignant and benign pleural effusions.

Total sialic acid (TSA), lipid-bound sialic acid (LSA), ferritin and carcinoembryonic antigen (CEA) were evaluated in 55 patients with malignant pleural effusions and in 32 patients with benign (exudative) pleural effusions. No significant differences were found in the pleural fluid TSA, LSA and ferritin levels between malignant and benign conditions. CEA levels in malignant effusions were significantly higher than those in benign effusions (43.13 +/- 72.8 ng/ml versus 2.6 +/- 5.56 ng/ml, p less than 0.01). At a cut-off level of 5 ng/ml, 60% of the patients with cancer showed elevated pleural fluid CEA levels. The specificity and diagnostic accuracy of CEA in distinguishing malignant from benign pleural exudates were both very high (91% and 71% respectively). Therefore, of the four markers investigated, only CEA could be a valuable tool in the detection of pleural malignancy.     

Serum sialic acid (TSA/LSA) and carcinoembryonic antigen (CEA) levels in cancer patients undergoing radiotherapy.

The main aim of this study was to evaluate the response of total Sialic Acid (TSA) and "Lipid-bound" Sialic Acid (LSA) compared to Carcinoembryonic Antigen (CEA), in 284 patients undergoing radiotherapy. Serial measurements of TSA by the enzymatic method (Boehringer-Mannheim Kit), LSA by the resorcinol-HC1 (Katopodis and Stock) and CEA by EIA (Abbott Kit) were performed in a total of 1017 blood sera. We statistically estimated the four greater groups of cancer patients [bladder (69), lung (58), uterus (31) and breast (29)]. Diagnostic marker sensitivities (% true positives) estimated from the 0-time-values--before initiation of radiotherapy--in relation to the established cut-off levels were in decreasing order: TSA 89.3% (80 mg/dL). LSA 88.8% (20 mg/dL) and CEA 26.75% (5 ng/mL). The overall tumor marker response to treatment, after its completion, estimated as % of patients with final blood serum levels of these markers, was in decreasing order: LSA 85.6%, TSA 81.3%, and CEA 65.8%. These data show that a) the diagnostic sensitivity of Sialic Acid (LSA/TSA) is more than 3 times higher than that of CEA and b) the response of Sialic Acid (LSA/TSA) to treatment is about 15% higher than that of CEA. In conclusion, this study confirms the high diagnostic sensitivity of Sialic Acid as a tumor marker and suggests that, with marginal superiority of Sialic Acid, all three markers are sufficiently responsive to be employed as adjunctive means in monitoring cancer patients underdoing radiotherapy.     

Multiple markers for lung cancer diagnosis: validation of models for advanced lung cancer

Sera from 171 patients with advanced lung cancer, from 110 normals, and from 123 subjects with benign respiratory diseases were analyzed for 10 substances to detect lung cancer: ferritin, lipid-bound sialic acid, total sialic acid, beta 2-microglobulin, lipotropin, the alpha and beta subunits of human chorionic gonadotropin, calcitonin (two assays), parathyroid hormone, and carcinoembryonic antigen. Individual markers were studied, and optimal combinations of markers were sought for discriminating lung cancer patients from normals and from patients with benign lung disease. Numerous methods for combining the markers were examined, but the methods of logistic regression and recursive partitioning were finally adopted. The best discrimination rules we could find used only carcinoembryonic antigen (CEA) and total sialic acid (TSA). The performance of these rules was validated on an independent serum panel containing sera from 68 patients with advanced lung cancer, from 40 normals, and from 52 patients with benign respiratory disease. The combination rules based on TSA and CEA performed better than a rule based on CEA alone. Logistic discrimination rules with TSA and CEA that were designed to have 95% specificity achieved 54% sensitivity for discriminating advanced lung cancer from normal controls and 52% sensitivity for discriminating advanced lung cancer from controls with benign disease. Some aspects of clinical applicability are discussed, including planned studies for localized lung cancer and the requirement for further testing in specific clinical settings.     

Serum neuron-specific enolase (NSE) in patients with small cell lung cancer--comparison with carcinoembryonic antigen (CEA)

Serum neuron-specific enolase (NSE) was determined by RIA in 102 lung cancer patients. Serum NSE was elevated (greater than 10 ng/ml) in 72% (21 of 29 cases) of small cell lung cancer (SCLC) patients, which was a significantly higher positive rate than those in normal adult controls (0%, 0/48), noncancerous lung disease (17%, 4/24), squamous cell carcinoma (19%, 6/31) and adenocarcinoma (16%, 4/25) (p less than 0.05, respectively). There were no NSE-positive cases in stage I-II lung cancer patients. In SCLC, cases of extensive disease had a significantly higher NSE-positive rate (100%, 8/8) than those of limited disease (62%, 13/21) (p less than 0.05), suggesting that NSE levels were related to the bulk of the tumor. There was an excellent correlation between serum NSE and clinical response. Raised NSE levels were identified significantly more frequently than those of CEA in SCLC before chemotherapy and on relapse (or progression) (p less than 0.025, p less than 0.005, respectively). Thus, serum NSE determinations may be more useful than those of CEA for the staging and monitoring of SCLC.     

Complementary roles of pro-gastrin-releasing peptide (ProGRP) and neuron specific enolase (NSE) in diagnosis and prognosis of small-cell lung cancer (SCLC)

In this study, we evaluated the clinical usefulness of ProGRP and NSE for diagnosis and prognosis of small-cell lung cancer (SCLC). Serum levels of ProGRP and NSE were determined in 108 healthy subjects, 103 patients with benign pulmonary diseases, 142 with non-small cell lung cancer (NSCLC), and 114 with SCLC. Sensitivity of ProGRP in diagnosis of SCLC was significantly higher than that of NSE (64.9 vs. 43.0%, P < 0.001). The difference was substantial in patients with limited disease (56.5 vs. 20.3%, P < 0.001). However, 11 of 40 SCLC patients with normal levels of serum ProGRP (27.5%) showed elevated levels of serum NSE. In the SCLC patients receiving chemotherapy, the CR rate in patients with elevated NSE levels was significantly lower than in patients with normal levels of NSE (18.5 vs. 61.7%, P < 0.001). Elevation of both ProGRP and NSE was a poor prognostic factor, and patients with elevated levels of either ProGRP or NSE showed shorter survival than those without. From multivariate analysis, NSE was found to have a greater effect on survival of SCLC patients than ProGRP. These findings indicate that ProGRP is more sensitive than NSE for diagnosis of SCLC, while NSE is superior to ProGRP as a prognostic factor. In conclusion, both ProGRP and NSE are useful tumor markers and they have a complementary role for each other in diagnosis and prognosis of SCLC.     

Evaluation of serum sialic acid, heat stable alkaline phosphatase and fucose as markers of breast carcinoma

Serum levels of total sialic acid (TSA), lipid bound sialic acid (LSA), heat stable alkaline phosphatase (HSAP) and fucose were measured in 39 patients with breast carcinoma, 14 patients with benign breast diseases and 35 healthy female individuals. Elevated levels of the four biomarkers in breast carcinoma were significant when compared with controls (p less than 0.001). Fucose levels were most sensitive (71.8%), while TSA levels were most specific (64.3%) for breast carcinoma. Sensitivity and specificity were 100% when combinations of LSA with fucose and TSA with HSAP were studied respectively. LSA was significantly elevated in infiltrating duct carcinoma patients compared with lobular carcinoma (p less than 0.001). TSA, HSAP and fucose also had lower mean values in lobular carcinoma as compared to infiltrating duct carcinoma. Increase in the levels of LSA and HSAP after surgical removal of the tumor in breast carcinoma occurred prior to the clinical evidence of the recurrence. The results indicate that the combination of the markers studied might be useful in breast cancer diagnosis and treatment monitoring.     

ProGRP、NSE单项及联合检测对恶性胸腔积液的诊断价值

目的 探讨血清和胸腔积液胃泌素前体释放肽片断31-98（ProGRP）、神经原烯醇化酶（NSE）单项及联合检测对小细胞肺癌（SCLC）和非小细胞肺癌（NSCLC）所致的恶性胸腔积液的诊断价值。方法 采用酶联免疫吸附实验检测36例SCLC（SCLC组）、37例NSCLC（非SCLC组）、36例良性胸腔积液患者（良性胸腔积液组）及35例健康对照者（健康对照组）血清和胸腔积液ProGRP、NSE水平。比较血清和胸腔积液ProGRP、NSE单项及联合检测对恶性胸腔积液的诊断价值。结果 SCLC组、NSCLC组血清和胸腔积液ProGRP、NSE水平均明显高于良性胸腔积液组及健康对照组（P〈0．01）；SCLC组血清及胸腔积液ProGRP、NSE水平均明显高于NSCLC组（P〈0。01）。SCLC组、NSCLC组、良性胸腔积液组及健康对照组的血清ProGRP阳性率分别为83.33％、8.11％、8.33％和2.86％，血清NSE的阳性率分别为72.22％、27.03％、22.22％和17.14％；SCLC组、NSCLC组和良性胸腔积液组胸腔积液ProGRP的阳性率分别为91。67％、2．70％和2.78％，胸腔积液NSE的阳性率分别为80.56％、21.62％和13.89％。血清ProGRP单项检测、NSE单项检测、ProGRP＋NSE联合检测（按序列实验）和ProGRP＋NSE联合检测（按平行实验）诊断SCLC所致的恶性胸腔积液的敏感度分别为0.8333、0.7222、0.7576和0.9167，特异度分别为0.9722、0．8611、1．0000和0．9167，Youden指数分别为0．8056、0.5833、0．7576和0．8333；胸腔积液ProGRP单项检测、NSE单项检测、ProGRP＋NSE联合检测（按序列实验）和ProGRP＋NSE联合检测（按平行实验）诊断SCLC所致的恶性胸腔积液的敏感度分别为0.9167、0.8056、0．8056及0.9444，特异度分别为1．0000、0.8889、1．0000及0．8889，Youden指数分别为0．9167、0．6944、0．8056及0．8333。对血清、胸腔积液ProGRP和NSE水平的检测，无论是单项或是联合检测，诊断NSCLC所致的恶性胸腔积液的敏感度、特异度及Youden指数均较低。结论 血清、胸腔积液ProGRP和NSE检测对SCLC所致的恶性胸腔积液均有一定的辅助诊断价值；胸腔积液ProGRP、NSE检测优于血清检测；ProGRP检测优于NSE检测；胸腔积液ProGRP单项检测对SCLC所致的恶性胸腔积液的鉴别诊断价值最高，其次为ProGRP＋NSE联合检测（按平行实验）；血清、胸腔积液ProGRP和NSE无论单项检测或是联合检测，对NSCLC所致的恶性胸腔积液均无诊断价值。     

The serum ferritin concentration is a significant prognostic indicator of survival in primary lung cancer.

The prognostic significance of serum ferritin on survival in lung cancer was evaluated. One hundred and ninety-seven patients were referred for evaluation of pulmonary lesions; 115 patients (85 men) had primary lung cancer. Their median age was 57 years. Seventy-four patients (43 men) with benign lung disease were enrolled as controls. Their median age was 53 years. Serum ferritin was measured at diagnosis. Non-small cell lung cancer (NSCLC) (n=90) was graded according to the TNM-system and small cell lung cancer (SCLC) (n=25) in limited and extensive disease. Follow-up was median 30 months (range 23-36). Patients with lung cancer had higher median ferritin than controls (245 vs. 145 microg/l, p<0.00001): the prevalence of ferritin >300 microg/l was 37% in patients with lung cancer and 14% in controls (p<0.001). There was no significant difference in ferritin between patients with different stages either in NSCLC or in SCLC. Patients with SCLC had higher median ferritin than patients with NSCLC (344 vs. 233 microg/l, p<0.05). No significant differences in ferritin could be demonstrated among the other histological tumour types. The overall survival rate in patients with lung cancer was 52% after 1 year, 33% after 2 years, and 13% after 3 years. Survival rate was lower in patients with ferritin >300 microg/l than in those with ferritin < or =300 microg/l (p<0.0001). The probability of survival 1, 2 and 3 years after diagnosis in patients with ferritin >300 microg/l was 36, 20 and 4%, respectively, and in patients with ferritin < or =300 it was 63, 42 and 18%, respectively (p<0.0001). An elevated ferritin was a significant prognostic factor (p<0.01) even after adjustment for performance status, age, sex, TNM stage, and histological tumour type. TNM stage and performance status were likewise predictors of survival (p<0.01 and p<0.001, respectively). There exists a clinically relevant relationship between serum ferritin concentration and the prognosis of survival in patients with primary lung cancer. The routine use of serum ferritin should be considered in the evaluation and follow-up of pulmonary malignancies.     

Cut-off levels of NSE to differentiate SCLC from NSCLC

Neuron-specific enolase (NSE) is a specific tumor marker in small cell lung cancer (SCLC) patients, however, it has been reported that serum NSE levels are elevated in some patients with non-small cell lung cancer (NSCLC). To determine the most suitable cut-off level to distinguish between these two types of cancers, NSE levels were measured on serum samples of 417 patients with lung cancer without clinical information. Receiver operating characteristic (ROC) curve showed 14.5 ng/ml as a cut-off level and the 95 percentile serum NSE level in NSCLC was 20.5 ng/ml. None of the NSCLC patients had serum NSE levels more than 70 ng/ml. The measurement of serum NSE provides a discrimination between NSCLC and SCLC. If an NSCLC patient presents with a NSE level >20.5 ng/ml, pathological features must be examined with regard to the neuroendocrine differentiation.     

血清肿瘤标志物检测在肺癌中的临床价值

目的研究肺癌患者血清癌胚抗原(carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(neuron-spe-cific enolase,NSE)、细胞角蛋白19片段(cytokeratin 19 fragments,CYFRA21-1)水平与肺癌分期、近期疗效的关系。方法5例确诊为肺癌的患者均完成4个周期化疗,化疗前后常规检查血清CEA、NSE、CYFRA21-1,评估其变化。结果 5例患者中血清肿瘤标志物表达阳性者占61.8%,其中小细胞肺癌(SCLC)为69.2%,非小细胞肺癌(NSCLC)为59.5%;血清CEA、NSE、CYFRA21-1表达阳性率:SCLC分别为30.8%、69.2%及7.7%;NSCLC分别为52.4%、14.3%及54.8%。CEA、NSE、CYFRA21-1表达阳性率SCLC广泛期高于局限期,差异有统计学意义(P<0.05);NSCLCⅢB期与Ⅳ期各组间比较,差异有统计学意义(P<0.05)。化疗后血清肿瘤标志物表达水平变化与近期疗效相关。结论血清肿瘤标志物CEA、NSE及CYFRA21-1与肺癌分期、近期疗效有关。肺癌晚期肿瘤标志物表达水平增高,化疗有效率明显下降。     

Multiple markers for lung cancer diagnosis: validation of models for localized lung cancer

Sera from 71 patients with localized lung cancer, from 70 normal controls, and from 73 patients with benign lung diseases were analyzed for 10 substances to detect lung cancer: ferritin, lipid-bound sialic acid, total sialic acid, beta 2-microglobulin, lipotropin, the alpha and beta subunits of human chorionic gonadotropin, calcitonin (two assays), parathyroid hormone, and carcinoembryonic antigen (CEA). Individual markers were studied, and optimal combinations of markers were sought for discriminating patients with localized lung cancer from normal controls and from patients with benign lung disease. Both logistic regression and recursive partitioning methods for discrimination were tried. The best rules involved only CEA and ferritin for discriminating patients with lung cancer from normal controls, and CEA and age for discriminating patients with lung cancer from those with benign lung diseases. The performance of these rules was validated on an independent serum panel containing sera from 56 patients with localized lung cancer, 75 normal controls, and 75 patients with benign lung diseases. Three rules designed to achieve 95% specificity against normal controls attained 14%-36% sensitivity for localized lung cancer in the validation panels, whereas three rules designed to achieve 95% specificity against benign lung diseases attained 30%-39% sensitivity. Some aspects of potential clinical applications are discussed.     

Prediction of Lung Cancer Based on Serum Biomarkers by Gene Expression Programming Methods

In diagnosis of lung cancer, rapid distinction between small cell lung cancer (SCLC) and non-small celllung cancer (NSCLC) tumors is very important. Serum markers, including lactate dehydrogenase (LDH),C-reactive protein (CRP), carcino-embryonic antigen (CEA), neurone specific enolase (NSE) and Cyfra21-1,are reported to reflect lung cancer characteristics. In this study classification of lung tumors was made basedon biomarkers (measured in 120 NSCLC and 60 SCLC patients) by setting up optimal biomarker joint modelswith a powerful computerized tool - gene expression programming (GEP). GEP is a learning algorithm thatcombines the advantages of genetic programming (GP) and genetic algorithms (GA). It specifically focuses onrelationships between variables in sets of data and then builds models to explain these relationships, and hasbeen successfully used in formula finding and function mining. As a basis for defining a GEP environment forSCLC and NSCLC prediction, three explicit predictive models were constructed. CEA and NSE are requentlyusedlung cancer markers in clinical trials, CRP, LDH and Cyfra21-1 have significant meaning in lung cancer,basis on CEA and NSE we set up three GEP models-GEP 1(CEA, NSE, Cyfra21-1), GEP2 (CEA, NSE, LDH),GEP3 (CEA, NSE, CRP). The best classification result of GEP gained when CEA, NSE and Cyfra21-1 werecombined: 128 of 135 subjects in the training set and 40 of 45 subjects in the test set were classified correctly,the accuracy rate is 94.8% in training set; on collection of samples for testing, the accuracy rate is 88.9%. WithGEP2, the accuracy was significantly decreased by 1.5% and 6.6% in training set and test set, in GEP3 was0.82% and 4.45% respectively. Serum Cyfra21-1 is a useful and sensitive serum biomarker in discriminatingbetween NSCLC and SCLC. GEP modeling is a promising and excellent tool in diagnosis of lung cancer.     

肺癌患者血清肿瘤标志物联合检测及临床意义

目的探讨肿瘤标志物CEA、DR70、NSE和CYFRA21-1单项和联合检测对肺癌诊断的价值,评价血清中4项标志物水平在肺癌不同病理类型及治疗前后的表达意义。方法采用酶联免疫法检测130例肺癌患者和50例肺部良性疾病患者血清4项标志物水平,并以100名健康人为对照。同时对其中80例肺癌患者进行治疗前后标志物水平检测。结果肺癌患者CEA、DR70、NSE和CYFRA21-1血清水平高于肺良性疾病患者和健康人,差异有显著性意义(均P<0.01),肺部良性疾病患者和健康人比较差异无显著性;4项标志物在肺癌不同病理类型中CEA和NSE总体比较均有差异,其中腺癌CEA水平均高于其他类型(P<0.05￣0.01),小细胞肺癌NSE水平高于其他类型(均P<0.01);治疗有效的肺癌患者治疗后4项标志物水平均明显下降,而治疗无效者治疗前后均无明显变化。4项标志物联合检测的敏感度(73.1%)和准确度(80.5%)明显高于单项敏感度(分别为45.4%、24.6%、36.2%、33.8%)及准确度(分别为65.7%、55.2%、63.5%、60.7%)。结论CEA、DR70、NSE和CYFRA21-1联合检测可明显提高肺癌的阳性检出率;联合检测对鉴别肺癌与肺部良性疾病、肺癌不同病理类型,尤其对未能取得病理和细胞学证实的肺癌患者有一定的参考价值。同时检测治疗后标志物水平可以评估预后,观察治疗效果,为临床医师选择和改进治疗方案提供依据。     

血清神经原特异性烯醇酶和胃泌素用于肺癌的临床价值

 目的 探讨血清神经原特异性烯醇酶（NSE） 和胃泌素用于肺癌的临床价值。方法 采用ABC-ELISA 和放免法检测30 例正常对照、25 例良性肺疾病、55 例非小细胞肺癌（NSCLC） 和15 例小细胞肺癌（SCLC） 血清NSE和胃泌素浓度。结果 血清NSE和胃泌素浓度在4 组间有显着性差异（ P< 0-001）.NSE 诊断SCLC 的敏感性、特异性和准确性是80 、88 和86 % ;胃泌素诊断NSCLC分别是69 、65 和60 % 治疗后,SCLC 组血清NSE 和胃泌素均显着下降（ P< 0-001） ,而NSCLC组仅有胃泌素降低（ P< 0-001）。结论 NSE 主要用于SCLC 的辅助诊断、术前组织学分型及疗效监测,而胃泌素用于NSCLC。     

五项血清肿瘤标志物联合检测在肺癌诊断中的应用

目的：探讨癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、鳞状上皮抗原（SCC）、细胞角蛋白19片段抗原（Cyfra21—1）和糖链抗原125（CA125）5项肿瘤标志物联合检测在肺癌诊断中的价值。方法：采用电化学发光法及酶化学发光法测定81例肺癌、32例良性肺病患者和30例健康人的血清CEA、NSE、SCC、cyfra21—1和CA125水平。结果：肺癌组血清CEA、NSE、SCC、Cyfra21—1和CA125的阳性检出率（分别为49．38％、55．56％、23．46％、62．96％、39．51％）明显高于良性肺病组和健康对照组。肺癌组5项肿瘤标志物阳性率随肿瘤临床分期而升高。其中CEA在肺腺癌中明显升高（P〈0．05），NSE以小细胞癌升高明显（P〈0．05），SCC在肺鳞癌中明显升高（P〈0．01），Cyfra21—1以非小细胞肺癌升高明显（P〈0．01）。5项肿瘤标志物联合检测比单项检测的阳性率和准确性更高。结论：外周血CEA、NSE、SCC、Cyfra21—1和CA125联合检测可提高肺癌的阳性检出率，CEA、NSE、SCC和Cyfra21—1对肺癌病理分型有重要的临床参考价值。     

Evaluation of a radioimmunoassay for neuron specific enolase in small cell lung cancer

A radioimmunoassay for neuron specific enolase (NSE), a marker of neuroendocrine differentiation, has been evaluated in small cell lung cancer (SCLC). In untreated patients 25/38 (68%) with localized SCLC had raised blood levels of NSE (greater than 13 ng ml-1), in extensive disease 34/39 (87%) patients had raised NSE levels. In patients with non-small cell lung cancer (NSCLC) the serum levels were raised in 16/94 (17%). In extensive tumours of non-pulmonary origin NSE levels were increased in 24/116 (20%) patients. Longitudinal studies indicated a good correlation between the response to chemotherapy and fall of NSE levels. Tumour progression was accompanied by a rising NSE in 25/29 patients, with doubling times of 7-90 days. In patients with progression with a normal NSE the recurrence was a NSCLC. Cerebral metastases occurring as the only recurrence during clinical complete remission were not accompanied by a rise of NSE. Serum NSE levels provides a valuable monitor for SCLC during and after chemotherapy.     

The value of tumour markers in lung cancer

The pre-treatment serum levels of neuron-specific enolase (NSE), phosphohexose isomerase (PHI) and circulating immune complexes (CC) as tumour markers were compared to measurements of standard haematology and biochemical indices in 73 patients with lung cancer, as an aid to differentiation of tumour type, estimating disease extent, predicting response to therapy and prognosis. Elevated NSE greater than or equal to 12.5 ng ml-1, PHI greater than or equal to 55 mgl-1 levels were observed in 55% of cases for NSE, 90% for PHI and 49% for CC. NSE was significantly elevated in 61% (25/41) of patients with SCLC (P less than 0.005) compared to 41% (13/32) with NSCLC. CC levels were significantly raised in 72% (23/32) of patients with NSCLC (P less than 0.05) compared to 32% with SCLC. The levels of NSE and PHI were not related to tumour stage but CC was significantly raised in limited compared to extensive disease in SCLC (P less than 0.05). Serum albumin was significantly lower in NSCLC compared to SCLC, and median values of alkaline phosphatase, gamma-glutamyltranspeptidase and aminoaspartate transferase were significantly higher in patients with extensive disease. The pre-treatment serum values of NSE, PHI, and CC did not predict the response to therapy or prognosis in the 73 patients with lung cancer. The most important prognostic factor was the number of abnormal routine laboratory parameters (greater than 4) in this group of patients.     

唾液酸作为肺癌标志物的ROC分析

用受试者试验特征性曲线（ROC）建立了血清TSA与LSA对肺癌与非癌患者的最佳诊断分界值（Cut－off），TSA为76mg／dl，LSA为23mg／dl，肺癌组TSA与LSA的含量均明显高林非癌组，同时比较了TSA与LSA的诊断灵敏度，特异性，符合率，ROCAUC和信息量。血清唾液酸作为肺癌标志物时，TSA与LSA的ROCAUC无显著性差异（P＞O．05），二者间信息量的u值为0．91，P＞0．05。提示只要选一个最佳cut－off值，单测血清TSA就有可能达到筛选肺癌的目的。     

唾液酸作为肺癌标志物的ROC分析

用受试者试验特征性曲线（ROC）建立了血清TSA与LSA对肺癌与非癌患者的最佳诊断分界值（Cut－off），TSA为76mg／dl，LSA为23mg／dl，肺癌组TSA与LSA的含量均明显高林非癌组，同时比较了TSA与LSA的诊断灵敏度，特异性，符合率，ROCAUC和信息量。血清唾液酸作为肺癌标志物时，TSA与LSA的ROCAUC无显著性差异（P＞O．05），二者间信息量的u值为0．91，P＞0．05。提示只要选一个最佳cut－off值，单测血清TSA就有可能达到筛选肺癌的目的。     

Neuron-specific enolase during chemotherapy of small cell lung cancer

Serum neuron-specific enolase (NSE) has been measured in 28 patients with small cell lung cancer (SCLC) and 90 patients with other forms of lung cancer (NSCLC), i.e., 28 with adenocarcinoma and 62 with squamous cell carcinoma. Increased NSE (greater than 12.0 micrograms/liter) was found in 71.4% of SCLC patients and in 22.2% of NSCLC patients. The predictive value of an increased NSE in identifying SCLC was only 50%, whereas the predictive value of a normal NSE in differentiating SCLC for NSCLC was 91%. Serial studies during chemotherapy of SCLC patients showed that the doubling time of NSE ranged from 7 to 127 days and the mean apparent half-life (AHL) of NSE to be 14 days. AHL values in excess of 20 days suggest that the tumour is not in full remission. We believe that measurement of serum NSE and calculation of the AHL and DT are valuable in identifying the effectiveness of chemotherapy in patients with SCLC.