Serum tumor markers in non-small cell lung cancer. A comparative analysis

Abstract

Background. The role of serum tumor markers in non‐small cell lung cancer (NSCLC) remains undefined. New proposed markers have seldom been rigorously compared with existing standards. The authors prospectively compared the performance of three new monoclonal antibodies (MoAb) (5E8, 5C7, and 1F10) with the established serum markers carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC). Methods. The cohort consisted of 45 consecutive outpatients with newly diagnosed NSCLC. Control subjects were 38 outpatients with non‐neoplastic chronic pulmonary diseases. Blood from each patient and control subject was assayed for all five tumor markers. An enzyme‐linked immunosorbent assay (ELISA) was used to determine 5E8, 5C7, and 1F10 reactivity. Commercially available kits were used to measure SCC by radioimmunoassay and CEA by ELISA. Individual and combinations of tumor markers were compared in terms of sensitivity, specificity, and accuracy for NSCLC diagnosis. Results. 5E8 plus 5C7 plus 1F10 significantly surpassed SCC plus CEA in terms of sensitivity (P < 0.05) and proved the most accurate marker combination. Among single markers, 5E8 was most specific, 5C7 most sensitive, and 5C7 and 1F10 each most accurate, but differences from CEA alone were not significant. Subgroup analysis by histologic type and stage demonstrated similar findings, and marker combinations yielded little additional diagnostic benefit. Conclusions. 5E8, 5C7, and 1F10 performed marginally better than did CEA and SCC in patients with newly diagnosed NSCLC. Many limitations apply in defining a clinical niche for these tumor markers in NSCLC, although 5E8, 5C7, and 1F10 previously have demonstrated a modest prognostic value. An adjunctive role in a few specific clinical contexts remains possible.

Prognostic value of combination of Cyfra 21-1, CEA and NSE in patients with advanced non-small cell lung cancer

“…Indeed, some studies showed a negative prognostic value for CEA 7,18 while others did not. [19][20][21] These discrepancies probably highlight the need for specific evaluation of CEA in distinct subgroups according to histology 22 or stage of disease. 17 Prognostic value of high NSE level did not reach statistical significance neither in univariate (p ¼ 0.08) nor in multivariate analysis.…”

Two Panels of Plasma MicroRNAs as Non-Invasive Biomarkers for Prediction of Recurrence in Resectable NSCLC

“…The search for non-invasive tumor biomarkers is rapidly expanding and investigation into circulating biomarkers is the subject of intense research. Several serum tumor markers such as the carcinoembryonic antigen or Cytokeratin-21-Fragment (CYFRA 21-1) may carry some prognostic and predictive information in NSCLC, although their use is currently limited and the biochemical methodologies used to measure them are still labor-intensive [7], [8].…”

Preoperative serum CA125 is an independent predictor for prognosis in operable patients with non-small cell lung cancer

“…The current tumor markers for NSCLC include carcinoembryonic antigen (CEA), soluble fragment of cytokeratin 19 (CYFRA21-1), tissue polypeptide antigen (TPA), neuron-specific enolase (NSE), carbohydrate antigen 125 (CA125), squamous cell carcinoma antigen (SCC) and some others [6][7][8][9][10]. Despite extensive studies so far, few are turned out to be useful in clinic.…”