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Tumor Markers (CEA, CA 125, CYFRA 21-1, SCC and NSE) in Patients with Non-Small Cell Lung Cancer as an Aid in Histological Diagnosis and Prognosis
Comparison with the Main Clinical and Pathological Prognostic FactorsMolina R.a · Filella X.a · Augé J.M.a · Fuentes R.c · Bover I.d · Rifa J.e · Moreno V.b · Canals E.c · Viñolas N.a · Marquez A.e · Barreiro E.c · Borras J.d · Viladiu P.c
aLaboratory of Clinical Biochemistry, Unit for Cancer Research, Hospital Clínic, and bUnit of Epidemiology and Cancer Registry, Hospital Duran i Reynals, Barcelona, and Departments of Oncology, cHospital Santa Caterina, Girona, dHospital San Joan de Reus, Tarragona, and eHospital Son Dureta, Palma de Mallorca, Spain
CEA, CA 125, SCC, CYFRA 21-1 and NSE were prospectively studied in 211 patients with non-small cell lung cancer and compared with clinical parameters (age, sex, Karnofsky Index, symptoms and smoking status), histopathological parameters (stage, histology, tumor size and nodal involvement), biological parameters (LDH and albumin) and the therapy used (surgery, chemotherapy or radiotherapy). Tumor marker sensitivity was CYFRA 21-1: 76%, CA 125: 55%, CEA: 52%, SCC: 33% and NSE: 22%. One of the tumor markers was abnormally high in 87% of the patients with locoregional disease and in 100% of the patients with metastases. Except for NSE, all tumor markers showed a clear relationship with tumor stage and histology and therefore enabled a better histological diagnosis. Abnormal CEA serum levels were mainly found in adenocarcinomas, CA 125 in large-cell lung cancers (LCLC) and adenocarcinomas and SCC in squamous tumors. Eighty-five percent of the patients with SCC levels >2 ng/ml had squamous tumors. Likewise, CA 125 levels <60 U/ml or CEA <10 ng/ml excluded adenocarcinoma or LCLC with a probability of 82 and 91%, respectively.
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