Clinical usefulness of serum assays of neuron-specific enolase, carcinoembryonic antigen and CA-50 antigen in the diagnosis of lung cancer

Bergman, Bengt; Brezicka, Fred-Thomas; Engström, Christer; Larsson, Sture

doi:10.1016/0959-8049(93)90174-e

Cited by 36 publications

(19 citation statements)

References 16 publications

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“…The specificity of CEA in this study was shown to be relatively good, reaching 96.1% (false-positive rate 3.9%) ( Table III). Previous studies have shown that CEA levels are elevated in 0-38% limited-stage small cell lung cancer (SCLC) patients and 40-65% in extensive-stage SCLC patients (27), as well as in 30-65% of non-SCLC patients (28). Results of another study have demonstrated that CEA levels were altered in glandular cancer with a high positive ratio and specificity (29).…”

Section: Discussionmentioning

confidence: 99%

Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment

Lü

Ren

et al. 2012

Molecular and Clinical Oncology

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Abstract. The present study aimed to assess the diagnostic/ prognostic value of various clinical tumor markers, including carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin 19 (CYFRA21-1), α-fetoprotein (AFP), carbohydrate antigen-125 (CA-125), carbohydrate antigen-19.9 (CA-19.9) and ferritin, individually or in combination. The electro-chemiluminescence immunization method was performed to detect the levels of seven tumor markers in 560 cancer patients and 103 healthy subjects for comparison. The serum levels of the seven markers measured in cancer patients were higher compared to healthy subjects (P<0.05 for AFP and P<0.001 for the remaining six markers). Different markers had different sensitivity towards different types of tumors. Combining more markers significantly increased the ratios of positive diagnosis in the tumors. The diagnostic sensitivities of combining seven markers were particularly high in digestive, urinary and skeletal tumors (82, 92 and 83%, respectively). Gynecological tumors have exhibited a constant yet relatively low positive diagnosis irrespective of the use of a single marker or combined markers. However, the increase in sensitivity when combining markers was accompanied by a decrease in specificity. Generally, combining more markers increased the tumor detection rates, while a combination of the seven markers provided the highest detection rate. Combined detection showed a particularly high sensitivity in detecting respiratory, digestive and urinary system tumors, with the lowest sensitivity observed in gynecological tumors. As a result, combining tumor markers may play an important role in early tumor detection/diagnosis while the loss of specificity can be tolerated.

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Section: Discussionmentioning

confidence: 99%

Combining multiple serum biomarkers in tumor diagnosis: A clinical assessment

Lü

Ren

et al. 2012

Molecular and Clinical Oncology

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“…The neuroendocrine marker serum neuron-specific enolase (NSE) is helpful in the diagnosis and monitoring of SCLC (Harding et al, 1990;Jorgensen et al, 1992;Bergman et al, 1993). Squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) have been extensively studied in patients with lung cancer; however, their sensitivity and specificity have usually been reported as low (Mizushima et al, 1991;Jarvisalo et al, 1993;Ebert et al, 1994).…”

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confidence: 99%

Clinical evaluation of seven tumour markers in lung cancer diagnosis: can any combination improve the results?

Plebani

Basso²,

Navaglia³

et al. 1995

Br J Cancer

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Summary In this study we compared the diagnostic utility of: (1) neuron-specific enolase (NSE); (2) squamous cell carcinoma antigen (SCC); (3) carcinoembryonic antigen (CEA); and (4) cytokeratin markers (CYFRA 21-1, TPA, TPM, TPS) in patients with small-cell lung cancer (SCLC) (21 cases) and non-small-cell lung cancer (94 cases). For comparison we also studied 66 patients with benign lung diseases and nine with pleural mesothelioma. NSE levels in SCLC patients were significantly higher than those in all the other groups studied. No significant variations were found among the SCC levels in all groups. CEA levels in patients with adenocarcinoma were significantly higher than those in all other groups studied. CYFRA 21-1 serum levels significantly increased in patients with squamous cell carcinoma and mesothelioma, while TPA, TPS and TPM increased in patients with lung cancer irrespective of the histological type. In patients with SCLC, high levels of all markers except SCC were found when the disease was extensive. In patients with non-SCLC, the highest levels of all tumour markers were usually found in those with advanced disease, although CYFRA 21-1 gave a sensitivity of 44% when a specificity of 95% was fixed in stage I non-SCLC patients. An analysis of receiver operating characteristic curves revealed that the highest diagnostic accuracies in distinguishing benign from malignant lung diseases were achieved with TPM (81%), CYFRA 21-1 (72%), CEA (78%) or TPA (78%) when using cut-off values of 46 U 1-', 3.0 g 1-g', 2.0 ;g l-l and 75 U l-1' respectively. When all patients were considered, the combined evaluation of more than one marker did not significantly improve the results obtained with TPM alone. However, taking into consideration the fact that CYFRA 21-1 is the most sensitive index of early lung tumours and that its combined determination with TPM did not worsen the overall sensitivity and specificity of the latter, the combined use of these two markers may be suggested as a useful took for the diagnosis of lung tumours.

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“…However, scanning methods are not appropriate for large numbers of patients or for repeated assays. Sensitive immunologic methods to measure antigens such as carcinoembryonic antigen (CEA), 23 squamous cell carcinoma antigen (SCC), 23 tissue polypeptide antigen (TPA), 23 cytokeratin (CK) 19 and 20, 23,24 collagen type I, 25 heterogeneous nuclear ribonucleoprotein (hnRNP) A2/B1, 26 parathyroid hormone-related protein (PTHrP) 27 or neuron-specific enolase (NSE) 28 have been studied for detection of lung cancer. The immunologic markers suffer from the difficulty of using sputum, antigen presentation by the immune system or sensitivity.…”

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confidence: 99%