TUMOR MARKERS KINETIC IN MALIGNANT LUNG NEOPLASMS

BACKGROUND: No studies about correlation between post-operative half-life of tumor markers and prognosis in lung cancer exist in literature. The aim of our study was to determine the half-life of CEA, TPA, NSE and CYFRA 21-1 in postoperative period after surgery of bronchogenic carcinoma, and to correlate it with the prognosis and survival of the patients. METHODS: From March 1997 to March 1998, 35 patients with bronchogenic carcinoma were studied (29 males and 6 females, mean age 64.9 years, range 51-77 and 61.0 years, range 52-77 respectively). The mean follow-up for males was 125.70 days (from 30 to 198) after surgery and for females 125.79 days (from 30 to 180). CEA and NSE were tested by immunoenzymatic automated method, whereas TPA and CYFRA 21-1 were assayed by immunoradiometric techniques. For each patient both the dismission curve and the half-life of considered markers were calculated during follow-up. RESULTS: A statistically significant difference was found for preoperative values of TPA (p = 0.027) and CYFRA 21-1 (p = 0.025) between SqCLC and adenocarcinoma. The preoperative levels of markers were higher in patients who would develop a relapse, even if statistical significance was not reached. CEA half-life was of 1.4 days, while in patients with a history of relapse or metastatic spreading was 4.5 days. No differences were revealed concerning CYFRA 21-1 between the two groups. CONCLUSIONS: Seriate determination of some markers (CEA and TPA in particular) during postoperative follow-up after surgery for bronchogenic carcinomas can be a useful prognostic tool. Longer follow-up would provide additional informations in order to determine individual predictive threshold between poor and good prognosis.