Utility of the serum tumor markers: CYFRA 21.1, carcinoembryonic antigen (CEA), and squamous cell carcinoma antigen (SCC) in squamous cell lung cancer

The aim of this study is to assess the clinical usefulness of serum assays of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), and CYFRA 21.1 in the diagnosis of squamous cell lung cancer. Sixty patients with squamous cell, and twenty-four patients with nonsquamous cell histology of nonsmall cell lung cancer were enrolled in this study. Serum CEA, SCC, and CYFRA 21.1 levels were obtained by commercially available kits. Upper cutoff levels were 10 ng/ml, 3.5 ng/ml, and 3.5 ng/ml, respectively. In squamous cell lung cancer, percentages and 95% confidence interval (CI) of the patients with elevated levels were as follows: for CEA 23.3% (13-36), for SCC 20.0% (10-32), and for CYFRA 21.1 85.0% (73-93). The positivity rate of CYFRA 21.1 was more significant than CEA and SCC in both squamous and nonsquamous cell lung cancer. None of the markers were significant in differentiating squamous/nonsquamous histology. Only tumor marker CEA was significantly elevated in metastatic squamous cell lung cancer (p=0.004). A novel tumor marker CYFRA 21.1 can be used as a reliable tumor marker in diagnosing squamous cell lung cancer. In addition, CEA has an important role in determining metastatic disease.     

Clinical investigation of neuron-specific enolase, squamous cell carcinoma-related antigen and carcinoembryonic antigen in carcinoma of the lung

Serum levels of neuron-specific enolase (NSE), squamous cell carcinoma-related antigen (SCC antigen) and carcinoembryonic antigen (CEA) were measured in 53 untreated patients with carcinoma of the lung. The positive rates of serum NSE were 17.0% in all patients with lung cancer, 53.8% in small cell carcinoma, 6.7% in adenocarcinoma, 5.0% in squamous cell carcinoma and 0% in large cell carcinoma; 0% in stage I, 14.3% in stage III and 26.7% in stage IV. The positive rates of serum SCC antigen were 45.3% overall, 70.0% in squamous cell carcinoma, 40.0% in adenocarcinoma, 23.1% in small cell carcinoma and 0% in large cell carcinoma; 42.9% in stage I, 57.1% in stage III and 46.7% in stage IV. In comparison with serum CEA, serum NSE and SCC antigen were much more specific in small cell carcinoma and squamous cell carcinoma, respectively. Moreover, serum levels of NSE and SCC antigen changed in parallel with the clinical course during the treatments. In conclusion, serum NSE and SCC antigen were considered to be very useful markers of lung cancer, especially of small cell carcinoma and squamous cell carcinoma, respectively.     

Evaluation of squamous cell carcinoma antigen as a new marker for lung cancer

Carcinoembryonic antigen (CEA) is the only tumor marker of proven, although limited, value for the management of patients with non-small cell lung cancer (NSCLC). The authors have prospectively assessed the potential value of a new tumor marker, squamous cell carcinoma antigen (SCC Ag), in a large series of patients with advanced lung cancer (LC). Squamous cell carcinoma antigen and CEA levels were measured in 382 healthy persons (N1 group), 90 patients with benign pulmonary diseases, and 291 patients with LC (129 with SCLC and 162 with NSCLC, including 96 with squamous LC). Carcinoembryonic antigen levels were higher in smokers than in nonsmokers, but smoking habits did not influence the serum concentrations of SCC Ag. Elevated values (above the 95th percentiles of N1, i.e., 7.5 ng/ml for CEA and 3.0 ng/ml for SCC Ag) were observed in 11.1% of patients with benign pulmonary diseases for both markers. Carcinoembryonic antigen was more sensitive than SCC Ag, even for squamous LC (56% versus 35% of elevated values, P less than 0.01). The specificity toward squamous LC was better, however, for SCC Ag, for which levels were elevated in only 8.5% of SCLC and in 18% of other forms of NSCLC, compared with 49% and 55%, respectively, for CEA. Moreover, measurement of SCC Ag and CEA levels did not give redundant information: thus, in squamous LC and SCC Ag level was elevated in 32% of the patients with a normal CEA level, increasing from 57% to 71% the proportion of patients with at least one elevated marker. Lastly, elevation of CEA or SCC Ag levels was an adverse prognostic factor in squamous LC (P = 0.05 for CEA; P = 0.07 for SCC Ag). In conclusion, SCC Ag appears to be worthwhile of further investigation in squamous LC. The authors found that this new marker provided additional information on CEA and that it was more specific for squamous LC than CEA.     

Evaluation of the soluble fragments of cytokeratin 19 (CK19) in non-small cell lung cancer (NSCLC)

This study compared the diagnostic efficacy of serum CK19 determination (Cyfra 21-1) with other tumour markers, such as CEA, SCC, NSE, TPA, in patients with resected non-small lung cancer. Tumour marker levels were tested in 90 patients with benign lung disease and at diagnosis in 72 patients with proven NSCLC, 39 squamous cell carcinoma and 33 adenocarcinoma. At presentation baseline levels of all tumor markers were significantly higher (p<0.05) in lung cancer patients than in control subjects, except for NSE. A significant increase (p<0.05) in serum concentrations was observed from stage I to stage IIIb only for Cyfra 21-1 (stage I/II, median=2.7 ng/ml; stage IIIb, median=6.3 ng/ml) and TPA (stage I/II, median=89.8 IU/ml; stage IIIb, median=170.7 IU/ml). Receiver operating characteristic (ROC) analysis was performed to evaluate the best threshold values and the global accuracy of each marker. The highest global sensitivity for NSCLC was reached by TPA (70.8%), whereas that of Cyfra 21-1 was 50%. According to tumour histology, significant difference (p<0.05) in serum levels were found only for CEA (adenocarcinomas, median=5.6 ng/ml; squamous cell carcinoma, median=3.2 ng/ml) and SCC (adenocarcinomas, median=1.0 ng/ml; squamous cell carcinoma, median=1.5 ng/ml). As regards squamous cell carcinoma histotype, the highest sensitivity was obtained by TPA (74.4% at a specificity of 62.2%) and for adenocarcinomas by CEA (78.8% at a specificity of 85.6%). Tumour marker levels were also determined during the follow-up of 10 patients. The best sensitivity in detecting relapses was shown by CEA (90%), followed by TPA (70%), SCC (50%), Cyfra 21-1 (40%) and NSE (10%), even though the CEA test displayed a high percentage of false positive results (98.1%) in patients with no evidence of disease (NED).     

肺鳞癌患者血清CYFRA21-1和SCC检测及ROC曲线和截断点的理论分析

目的:探讨血清细胞角蛋白19片段(CYFRA21-1)抗原和鳞癌抗原(SCC)对肺鳞癌的临床意义.方法:将研究对象分组,试验组为102例肺鳞癌患者,对照组为53例良性肺病患者.分别采用电化学发光法和酶联免疫法检测血清CYFRA21-1及SCC,测定值用t检验,率比较用x2检验.接受者工作特征(ROC)曲线及截断点选择理论评估CYFRA21-1及SCC的临床价值.结果:肺鳞癌组与良性肺病组CYFRA21-1和SCC水平差异有统计学意义;CYFRA21-1以3.3 ng/mL、SCC以1.5 ng/mL为诊断临界点,CYFRA21-1诊断肺鳞癌敏感性为57.84％,特异性为92.45％,准确性为69.68％,ROC曲线下面积为0.788;SCC诊断肺鳞癌敏感性为33.33％,特异性为92.45％,准确性为53.55％,ROC曲线下面积为0.691;CYFRA21-1诊断肺鳞癌最佳截断点为2.485或2.365 ng/mL,对应敏感性和特异性分别为65.7％、92.5％和67.6％、90.6％;SCC诊断肺鳞癌最佳截断点为0.55 ng/mL,对应敏感性和特异性分别为72.5％和62.3％.随肺鳞癌分期增高,CYFRA21-1和SCC浓度增高差异有统计学意义,CYFRA21-1敏感性增高差异有统计学意义,SCC敏感性无明显变化.结论:CYFRA21-1对肺鳞癌的诊断具有较高的临床价值,而SCC对肺鳞癌的诊断价值较低.     

Serum neuron-specific enolase as a marker of lung cancers

Neuron-specific enolase (NSE) in sera of lung cancer patients was studied in order to evaluate its clinical significance as a tumor marker. The subjects included 15 normal volunteers, 13 cases without malignant neoplasms or neuronal diseases and 42 lung cancer cases. NSE was quantified by a double antibody radioimmunoassay. As one of the sera from normal volunteers and control patients showed an NSE content 10 ng/ml or more, values of 10 ng/ml or over were considered to be positive. Seventeen of 42 sera from lung cancer patients showed positive NSE levels. Histological evaluation revealed that the degrees of NSE positiveness for small cell carcinoma, large cell carcinoma, squamous cell carcinoma and adenocarcinoma were 73%, 50%, 33%, and 21%, respectively, and that all the positive cases except for one were confined to disease stages III or IV. The level of NSE in patients with 10 ng/ml or more before surgery decreased to within normal limits 1-2 weeks after surgery Localization of NSE could be confirmed immunohistologically in small cell carcinoma cells. In conclusion, NSE was considered to be very useful as a tumor marker of the lung, especially in small cell carcinoma for diagnosis and determination of disease extent and response to therapy, and also in non-small cell carcinoma for the evaluation of treatment effectiveness.     

Diagnostic value of SCC-TA4 determination in 4 localizations of epidermoid cancers. An experience of the FNCLCC subgroup of radio-analysis

A multicenter and retrospective study of the diagnosis value of SCC-TA4 in squamous cell carcinomas of 4 localisations was made with the 2 thresholds of 2 and 2.5 ng/ml. However, 3.1% of controls have a SCC value above 2.5 ng/ml. Sixteen benign gynecologic pathologies had no positive level. The benign digestive (N = 73), bronchial (N = 345) pathologies and no squamous cell carcinomas (N = 93, N = 220 respectively), had SCC-TA4 mean levels significantly lower than corresponding squamous cell carcinomas (N = 153, N = 128 respectively). Sensitivity of the test varied from 40% in the squamous cell carcinomas of the lung, to 72% in the squamous cell carcinomas of the uterine cervix. Specificity was always very high and varied from 91% in the SCC of lung, to 100% in the SCC of uterine cervix. For the SCC of uterine cervix, oesophagus and head and neck, the mean values and incidence of positive levels increased significantly with increasing tumor size and advancing disease stage. For the SCC of uterine cervix, mean SCC-TA4 levels and percentages of positive levels above 2 ng/ml were significantly higher for the patients with recurrence (22.5 +/- 4.6 ng/ml; 76%) or with metastasis appearance (23.6 +/- 5.4 ng/ml; 77%) than for the patients in remission (less than 1.5 ng/ml; 0%). In the SCC of oesophagus, we report levels before treatment that are significantly higher for the patients with metastasis at the first attempt (4.2 +/- 5.1 ng/ml; 59%), and an elevated SCC level at the diagnosis evoked a SCC of lung already disseminated (8.8 +/- 12.1 ng/ml; 50%) that will fail to respond to treatment (4.0 +/- 4.2 ng/ml; 48%).     

Detection of squamous cell carcinoma antigen in normal squamous epithelia and in squamous cell carcinomas of the uterine cervix

Squamous cell carcinoma (SCC) antigen is a subfraction of tumor antigen TA-4 isolated from a cervical squamous cell carcinoma. The specificity of SCC antigen and the factors influencing its release into serum were evaluated. Antigen concentrations were measured in 157 tissue extracts and in 188 sera of patients with nonmalignant or malignant gynecologic diseases. A commercial radioimmunoassay based on polyclonal antibodies (Abbott Laboratories, North Chicago) was used. Cytosol concentrations were significantly higher (P less than 0.005) in normal squamous epithelia (means = 6040 ng/mg cell protein [CP]) and in squamous cell carcinomas (means = 2483 ng/mg CP) of the exocervix than those in normal columnar epithelia and in adenocarcinomas of the endocervix, endometrium, ovary, and breast (means = 1-508 ng/mg CP). Despite the high antigen concentrations in normal squamous epithelia, elevated serum levels (greater than 2.5 ng/ml) were almost exclusively found in patients with cervical squamous cell carcinomas. The sensitivity of SCC antigen as a marker for primary carcinomas was 61%, increasing from 29% in Stage I to 89% in Stage IV. The positivity rate was higher in women with well-differentiated (78%) and moderately differentiated carcinomas (67%) than in those with poorly differentiated tumors (38%). The results show that SCC antigen is not tumor specific. The release into serum is independent of local tissue content, but is apparently influenced by the infiltrative growth, the mass, and the degree of histologic differentiation of the tumor.     

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。     

A comparison of serum Cyfra 21-1 and SCC AG in the diagnosis of squamous cell esophageal carcinoma]

Cyfra 21-1 is a useful marker in lung cancer. The only tumor marker used at the present time in oesophageal squamous cell carcinoma (OSCC) is SCC (squamous cell carcinoma). In this study we evaluated the pre-treatment sensitivity and specificity of these two markers in this setting. Cyfra 21-1 and SCC were determined by radio-immunoassay on 76 patients having OSCC. Staging was done according to the UICC 1978 classification based on endoscopy, baryum enema and CT scan. The sensitivity of Cyfra 21-1 is better at the 1.5 ng/ml level (54%) than at the usual reported level of 3.6 ng/ml (26%). The best level for sensitivity of SCC is 1.5 ng/ml. At these levels, sensitivity of Cyfra 21-1 and SCC for advanced stages (T3 or M1) are respectively 72% and 50%. The specificity of Cyfra 21-1 and SCC for stages T1 or T2 are respectively 53% and 73%. The combination of these two markers increase sensitivity at 64% for all stages and at 89% for advanced stages (T3 or M1) and is a significant prognostic factor for survival. This study confirms the value of Cyfra 21-1 in OSCC at the normal level of 1.5 ng/ml. The combination with SC improves the results. We now need to evaluate the role of these two markers in the follow up of oesophageal carcinoma.     

Clinical significance of the number of positive tumor markers in assisting the diagnosis of lung cancer with multiple tumor marker assay

The clinical significance of multiple tumor marker assay in assisting the diagnosis of lung cancer was assessed in 67 patients with primary lung cancer, and 115 with nonmalignant pulmonary disease. The tumor markers studied were carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), squamous cell carcinoma-related antigen (SCC), and tissue polypeptide antigen (TPA). The positive rates for all of the tumor markers were significantly higher in the lung cancer group than in the nonmalignant pulmonary disease group. The sensitivity was 31-66%, the specificity was more than 90% for all five markers, and the accuracy was 69-82%. Among the markers, the positive rate of CEA was best correlated with adenocarcinoma (Ad), NSE with small cell carcinoma (Sm), SCC with squamous cell carcinoma (Sq), CA19-9 with Ad, and TPA with Ad. In multiple tumor marker assay, as the number of combined markers was increased, the sensitivity of the assay became higher and the specificity became lower, resulting in a lower accuracy. However, when more than two markers were positive, the relative possibility of lung cancer was increased 90-100%. The number of positive tumor markers in multiple tumor marker assay indicated that it would be of auxiliary value for the diagnosis of lung cancer.     

Clinical significance of serum basic fetoprotein and various tumor markers in primary lung cancer

Background To investigate the clinical significance of basic fetoprotein in lung cancer, serum basic fetoprotein was measured in 81 patients with primary lung cancer and 40 patients with other nonmalignant pulmonary diseases. Methods For comparison, various tumor markers such as carcinoembryonic antigen, sialyl Lewis^x-1 (SLX), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), tissue polypeptide antigen, squamous cell carcinoma related antigen (SCC), and neuron specific enolase were also measured. Results Fifty-nine percent of the patients with primary lung cancer had a positive basic fetoprotein level. This rate was higher than that for carcinoembryonic antigen and tissue polypeptide antigen, but lower than that for SLX. Histologic classification showed that basic fetoprotein occurred more frequently in small cell and large cell carcinomas. Carcinoembryonic antigen and SLX showed high specificity in adenocarcinoma, and SCC and neuron specific enolase showed high specificity in squamous cell and small cell carcinoma, respectively. Basic fetoprotein levels tended to be higher in the advanced stages of disease, and the change of basic fetoprotein levels was related to chemotherapeutic response. However, this tendency was not observed in patients who did not respond to chemotherapy; this was particularly pronounced in those with small cell carcinoma. In the study of various tumor markers, a correlation was observed only between basic fetoprotein and neuron specific enolase, which suggests that these 2 tumor markers are valuable in a combination assay. Conclusion The measurement of basic fetoprotein is a useful method for monitoring the effectiveness of treatment in primary lung cancer.     

CYFRA21—1检测在食管鳞癌中的临床应用价值

目的 研究细胞角蛋白19可溶性片段（CYFRA21－1）在食管鳞癌中的浓度变化及临床意义。方法 采用免疫放射法（IRMA）检测35例食管鳞癌患者血浆中的CYFRA21－1、SCC抗原及CEA的浓度,研究其浓度与其临床病理因素的相关性;比较27例手术治疗患者术前、术后第1天和术后第7天的浓度变化。结果 在35例食管鳞癌患者中,20例CYFRA21－1阳性（＞3.5ng/ml）,其特异性、敏感性及正确性分别为100.0%,57.1%,66.7%,联合检测CYFRA21－1及SCC抗原,其敏感性可达77.1%;术前与术后相比,CYFRA21－1血浆浓度有非常显著性差异（P＜0.01）,术后CYFRA21－1血浆浓度呈梯度下降;CYFRA21－1血浆浓度与食管鳞癌的临床病理因素相关（肿瘤大小、肿瘤侵犯程度、淋巴结转移及切除率）。结论 CYFRA21－1是食管鳞癌的有效肿瘤标志物,联合检测CYFRA21－1和SCC抗原对于判断肿瘤的复发和转移具有重要的临床意义,CYFRA21－1可作为判断食管鳞癌患者预后的重要指标之一。     

血清肿瘤标志物在肺癌诊断中的应用价值*

目的:探讨SCC 、NSE、CEA 、CYFRA21-1 四项肿瘤标志物联合检测对肺癌的诊断价值。方法:采用化学发光法对肺癌组132 例、肺良性疾病组48例和正常对照组92例的血清SCC 、NSE 、CEA 、CYFRA21-1 四项肿瘤标志物进行检测及统计学分析。结果:NSE 、CEA 、CYFRA21-1 在肺癌组显著高于肺良性疾病组和正常对照组,SCC 肺癌组高于正常对照组,CEA 和CYFRA21-1肺良性疾病组显著高于正常对照组。CEA 在肺腺癌中的水平较高,NSE 在小细胞肺癌中的水平较高,而SCC 、CYFRA21-1 在肺鳞癌中的水平较高。单项肿瘤标志物在肺癌诊断中敏感性:NSE>CEA>CYFRA 21-1>SCC;在腺癌中CEA 敏感性最高（58.8%）,鳞癌中CYFRA21-1 敏感性最高（71.4%）,小细胞肺癌中NSE 敏感性最高（50.0%）。 NSE 、CEA 、CYFRA21-1 的ROC 曲线下面积分别为0.928 ± 0.034、0.957 ± 0.026、0.964 ± 0.023,显示诊断准确性较高。SCC 曲线下面积虽然大于0.5,但差异无统计学意义。肿瘤标志物联合检测,可以提高诊断试验的敏感性,在肺癌诊断中NSE 、CEA 、CYFRA21-1 组合敏感性最高（75.6%）,特异性也较好（90.7%）;腺癌诊断中SCC 、NSE 、CEA 组合敏感性最高（73.5%）,鳞癌诊断中NSE 、CEA 、CYFRA21-1 组合敏感性最高（75.8%）,小细胞肺癌中SCC 、NSE 、CYFRA21-1 组合敏感性最高（75.0%）。 结论:SCC 、NSE 、CEA 、CYFRA21-1 对肺癌的诊断均有一定意义,不同病理类型各有特点,选择合适的组合有利于对肺癌的鉴别诊断。      

Clinical Usefulness of CYFRA Assay in Diagnosing Lung Cancer: Measurement of Serum Cytokeratin Fragment

We evaluated the diagnostic usefulness of measurement of the soluble cytokeratin 19 fragment, a new tumor marker, in 391 patients with lung cancer and in 424 patients with benign lung diseases. Serum concentrations of cytokeratin 19 fragment were measured by a sandwich ELISA (CYFRA). The cut-off value was defined as 3.5 ng/ml, which is associated with a specificity of 85% for benign lung diseases. CYFRA had a high sensitivity (57.5%) in all subjects with lung carcinoma, and had a higher sensitivity for squamous cell carcinoma (73.1%, n = 141) than squamous cell carcinoma-related antigen (61.0%). CYFRA was associated with a relatively high sensitivity (42.1%) in early-stage squamous cell carcinoma (stage I, based on the classification of the Japan Lung Cancer Society), but the CYFRA titer was higher in advanced squamous cell carcinoma than in early-stage squamous cell carcinoma. Our findings suggest that CYFRA is potentially useful for diagnosis and monitoring of lung carcinoma, especially for squamous cell carcinoma.     

原发性肺癌患者血清中相关肿瘤标志物表达水平的变化及其临床意义

目的探讨肿瘤标志物[癌抗原125、CY211、癌胚抗原、鳞状细胞癌抗原(SCC)及神经原特异性烯醇化酶(NSE)]在原发性肺癌患者血清中的变化情况及意义。方法选取肺癌患者50例(甲组)、肺良性疾病患者50例(乙组)及健康人群50例作为研究对象,并采用化学发光法检测3组肿瘤标志物表达水平。结果甲、乙组各项肿瘤标志物水平明显高于健康人群组,差异具有统计学意义,P<0.05。甲组患者癌胚抗原(CEA)及CY211(cytokeratin-19-fragment,CY211)水平明显高于乙组(P<0.05)。与临床手术组织病理检查结果比较,小细胞肺癌患者神经原特异性烯醇化酶(neuron specific enolase,NSE)阳性率较其他类型肺癌高,而腺癌患者中癌抗原125(CA125)阳性率最高,鳞癌患者中CY211阳性率表达最高,P<0.05。结论检测肿瘤标志物,尤其是血清CEA、CY211,有助于肺癌诊断;同时检测不同肿瘤标志物还有利于肺癌的临床病理分型,从而可为临床治疗提供指导价值。     

鳞癌相关抗原、癌胚抗原及糖链抗原15—3在诱发性肺鳞癌癌变过程中的研究

目的　探讨肺癌形成发展过程中血清鳞癌相关抗原 (SCCAg)、癌胚抗原 (CEA)及糖链抗原 15 3(CA15 3 )的动态变化 ,为寻找有意义的肺癌早期诊断指标提供依据。方法　经肺叶支气管内灌注甲基胆蒽(MCA)碘油溶液对 91只Wistar大鼠诱癌 ,分别于灌注后第 2 0、40、5 0、60、70、80天分批处死动物并采取血清。从经病理确诊为不典型增生、原位癌及早期浸润癌各阶段的动物模型组中各选取 3～ 7例 ,应用微粒子酶免疫试验技术 (MEIA)测定血清中SCCAg、CEA、CA15 3的水平。结果　在不典型增生、原位癌阶段 ,三种标志物均无改变 ;但在早期浸润癌阶段 ,血清SCCAg明显增高 ,其差异有统计学意义 (P <0 .0 1) ,而CEA、CA15 3无明显改变。结论　血清SCCAg在肺鳞癌早期即升高 ,表明SCCAg是肺鳞癌早期诊断的一个很有意义的指标。     

肺癌患者血清CA125检测的临床应用

目的:探讨CA125对肺癌鉴别诊断和观察疗效的临床意义。方法:采用免疫放射分析法测定健康人和按组织学分类的各类肺癌患者血清CA125水平及阳性率,同时检测各样品的血清CEA水平,进行统计分析。结果:患者组较健康对照组CA125水平显著增高(P<0.01)。肺鳞癌组CA125阳性率为84％,腺癌为65％,腺鳞癌为56％,小细胞肺癌为40％;1例大细胞肺癌CA125检测值为230U/ml、CEA值为18ng/mL。肺鳞癌阳性率较其它组x~2检验有显著意义(p<0.01),CA125与CEA呈正相关(R=0.852)。结论:血清CA125可作为对肺癌早期诊断、鉴别诊断及观察疗效的较好参考指标。     

Prognostic value of pretreatment serum carcinoembryonic antigen and squamous cell carcinoma antigen levels for patients with stage I–III non-small cell lung cancer treated with radiation therapy alone

Background Serum carcinoembryonic antigen (CEA) and serum squamous cell carcinoma antigen (SCC Ag) levels have been reported to be useful as prognostic factors, indicators of clinical response, and predictors for recurrence in patients with lung cancer treated by surgery or chemotherapy. We investigated whether pretreatment serum CEA and SCC Ag levels were useful as independent prognostic factors in patients with stage I to III non-small cell lung cancer who were treated with radiation therapy alone. Methods The serum CEA and SCC Ag levels were measured in 158 and 47 patients, respectively, before radiation therapy. Serum CEA and SCC Ag levels were measured by sandwich radioimmunoassay using the CEA-RIA (radioimmunoassay) kit and the SCC-RIA kit. Results Serum CEA and SCC Ag levels were above reference values in 19% and 30% of the patients, respectively. The 5-year survival rates were significantly better for patients with a nagative SCC Ag result than for those with positive SCC Ag levels (P=0.0001), though no significant difference in survival rates was seen by CEA positivity (P=0.25). SCC Ag positivity (P=0.0006) and stage (P=0.04) were the important prognostic factors, as determined by multivariate analyses. Conclusion Pretreatment serum SCC Ag level may be useful as an independent prognostic factor in patients with stage I to III non-small cell lung cancer who are treated with radiation therapy alone.     

Increased serum midkine concentration as a possible tumor marker in patients with superficial esophageal cancer

Midkine, a heparin-binding growth factor, is expressed in numerous cancer tissues and is reportedly elevated in patients with various neoplasms. The aim of this study was to evaluate the clinicopathological significance of serum midkine concentration (S-MK) in patients with superficial esophageal squamous cell carcinoma (SCC). Pretreatment S-MK was measured by enzyme-linked immunosorbent assay in 135 healthy controls, 16 patients with benign esophageal disease, and 60 patients with primary superficial esophageal squamous cell cancer (SESCC). All patients with SESCC underwent curative resection. The disease was staged according to TNM/UICC guidelines. Serum concentrations of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), and cytokeratin 19 fragment (CYFRA21-1) were also evaluated in the same populations. S-MK in patients with SESCC (388+/-411 pg/ml) was significantly higher than in benign esophageal disease or healthy controls (183+/-73 and 154+/-76 pg/ml, respectively). Using the mean + 2 standard deviations of healthy control S-MK (300 pg/ml) as the cut-off level, 50% of patients with esophageal SESCC were deemed positive. This S-MK positivity rate for detecting SESCC was significantly higher than for other tumor markers. Thus, S-MK may be useful as a tumor marker to detect SESCC.