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SERUM MARKERS CASA, CEA, CYFRA, TPS, AND NSE IN LUNG CANCER P.L.Devine. KMFong’. R.J.Quin, BScells’, M.A.McGuckin, and P.V.Zimmerman’. The University of Owensland. Australia; ’ Dept.Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia: Suppurted by a Queensland Cancer Fund Grant.

A reliable marker would be useful in the management of lung cancer. A “umber of serum markers for this disease have been described (CASA. CYFPA, CEA, NSE, TPS), but few comparisons of these markers have been performed, and little has been reported on the clin!cal utility of these markers.

A pilot study has indicated the potential utilky of a number of serum assavs in the manaoement of luno cancer (Table 1). Table 1’ Percentaoebf Patients Above Recu&s&i Assav Cutoolnt Grour, Assav: TpS CYFR4 CASA CEA NSE

cutoff: fso1 &!l&@ &@ (12.5) Lung Cancer in = 54) 63 54 46 24 22 Benign Lung (n = 55) 16 11 16 2 5 Healthy Controls (n = 56) 11 0 2 2 0

TPS and CYFPA were mainly elevated in squamous cell carcinomas (TPS 74%. CYFFIA 70%). In neuroendocrine turnours, NSE showed the highest sensitivity (50%) followed by CASA (33%). CYFRA and CASA were mainly elevated I” easily diagnosed infectious conditions; only 3% of non-infectious benign conditions were elevated with these markers.

Receiver-Operator analysis was performed to compare assays at the same specificity. CYFRA was superior to all other assays in this analysis. The combwd use of assays was also investigated. The addition of CASA to CYFRA increased sensitivitv from 54% to 72% in LC and from 58% to 77% in “on-small cell LC. while the addition of CASA to NSE increased sensitivity from 50% to 83% in neuroendocrine turnours. One year survival data was available for 22 patients with LC. CASA was the only marker which correlated significantly wth survival (83% for CASA < 5 U/mL; 10% for CASA 2 5 U/mL), and this was superior to stage and age.

Preliminary results of an ongoing prospective study will be presented. These indicate that some of these markers are unlikely to be useful m the initial diagnosis but may be useful indicators of residual disease after surgery, the response to chemotherapy or radiotherapy, and preclinical recurrence.

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EVALUATION OF CLINICAL USEFULNESS OF CAW 123-6, A NEW TUMOR MARKER FOR PULWONARY ADENOCARCINOMFI. N.Kohno. 8. Ramada, S. Watanabe', S. Fujioka. S. Fujino, K. Eiwada. Ehime University School of Medicine and 'Matsuyama Red Cross Hospital., Ehime, Japan. &7c&7r0um3 we establ.ished a new tumor marker CAW 123-6 for pulmonary adenocarcinoma (Jpn J Cancer Res, 85 (2) in press). CAM 123-6 is one of molecules of Cluster 9 (MUC 1)(3rd Interna- tional IASLC Workshop on Lung Tumor and Differ- entiation Antigens). Abnormally elevated serum levels of CAM123-6 were observed in 599 (22/37) of patients with pulmonary adenocarcinoma, but no patients with squamous cell lung cancer In= 28) and small cell lung cancer (n=151. NOnmalig- nant lung diseases (n=28) showed no abnormal levels. Purpose To assess the value of CAM 123-6, we evaluated the effects of chemo-radiotherapy in patients with pulmonary adenocarcinoma and com- pared the serodiagnostic value of CAM123-6 with that of CYPRAII-1 fcytokeratin 19 fragment). Result 9 In patients with pulmonary adenocar- cinema who showed partial response, serum levels of CAW123-6 decreased, but in patients who show- ed progressive disease, the levels increased or did not so much change. Serum level of CYFRA~~-1 was abnormally elevated in 60% of patients with pulmonary adenocarcinoma, but in 12% of patients with nonmalignant lung disease as well. COnClUSiona CAM 123-6 levels changed reflect- ing disease status of pulmonary adenocarcinoma and the specificity was superior to CYFRA~~-1, while the sensitivity was same.

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CYFRA 21-l:A MARKER OF LUNG CANCER

Felletti R:,ChessaL.,"Cerri E?,Ropolo FZ,RattoG. Spessa E ';Giorgi G,;Onetto M.: “San martin0 Hospital,1 2 Chest Division,Institute of Clinical Surgery University,National Cancer Institute GENOVA Italy. Cytocheratin 19 is a protein of the cytoskeleton expressed in the bronchial tree.This protein is o verexpressedin lull carcinoma tissue,but can also released in bloodstream.Cyfra concentretion was mesured in 95 healthy volunteers,in 52 patients with benign lunq diseases,in 71 pts with lunq ca. at the diagnosis and in 9 pts after surqery for Lung ca.Cyfra was determined with the immunometric assay,CYFRAZl-1,provided by Boehringer Mannheim, utilizinq two specific monoclonal antibodies,BM19- -21 and KS19-l.The mean level and standard devia- tion obtained in normal subjects were 0.98+0.72 ng/ml.The selected cut-off was 3.2(mean+3SD);only 2 of 96healthy blood donorshad serum CYFRA values above this 1evel.I" table 1 are shown the percenta ges of CYFRA positivity. TAB1

Benign lung diseases ,z CYFRA Nt %Positivity

7 13,5

Malignant"" " 71 42 59,2 -Squamous L.cancer 41 27 65,8 -Adenocarcinoma 13 6 46,2

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