Serum deoxythymidine kinase in small cell carcinoma of the lung: Relation to clinical features, prognosis, and other biochemical markers

Abstract

Thymidine kinase (s-TK), lactate dehydrogenase (LDH), and carcinoembryonic antigen (CEA) were determined in pretreatment serum from 125 patients with small cell carcinoma of the lung. The distribution of marker levels into three ranges, when including all patients were as follows: s-TK less than 5 units 49%, 5-less than 10 units 25%, greater than or equal to 10 units 26%; LDH less than 6.7 mukat 31%, 6.7-less than 13.4 mukat 48%, greater than or equal to 13.4 mukat 21%; CEA less than 7.5 micrograms/l 51%, 7.5-less than 15 micrograms/l 25%, greater than or equal to 15 micrograms/l 24%. The percentages of patients with limited and with extensive disease within each range were s-TK less than 5 82/18, 5-less than 10 29/71, greater than or equal to 10 9/91; LDH less than 6.7 76/24, 6.7-less than 13.4 51/49, greater than or equal to 13.4 21/79; CEA less than 7.5 70/30, 7.5-less than 15 39/61, greater than or equal to 15 23/77. Analyses in relation to metastases present showed that patients with skeletal and bone marrow metastases had significantly higher s-TK and LDH than those without, while this was not the case for CEA. A strong correlation between s-TK and LDH level, a weaker correlation between CEA and s-TK, and no correlation between CEA and LDH level, was found. Both the level of s-TK and LDH correlated to the patients' performance, as defined by the Karnofsky index. These correlations were mainly confined to the patients with extensive disease. Analyses of the prognostic capacity of variables showed that s-TK, stage, and Karnofsky index could divide the patients into groups with highly significant difference in survival time, while LDH and CEA were of less value. Longitudinal studies showed that the serum markers mirrored the disease activity, with the exception that highly increased s-TK was found during remission induction for some patients. It was concluded that the expression of pathologic levels for the serum markers were dependent on different biological parameters. Of the serum markers, only s-TK was judged useful for estimation of disease spread and prognosis of the individual patient.

Serum thymidine kinase, a possible marker for monitoring the effect of bone marrow transplant treatment in early recovery phase

“…Clinical application of the Prolifigen TK-REA technique was previously reported by several authors in patients with malignant disorders and those with non-malignant disorders. [3][4][5][6][7][8][9][10][11][12][13][14][15] Hogberg et al 12 suggested that the bone marrow cells in patients with B 12 deficiency have a defect in DNA synthesis, resulting in the accumulation of immature proliferating bone marrow cells locked at the stage of TK production and release. In a study of patients with untreated B,2 deficiency, serum TK activity was found to be closely correlated with the extent of bone marrow insufficiency, with very high levels being observed in those with the most severe haematological disorders.…”

Clinical and Biological Significance of Serum Tumor Markers in Adult T-cell Leukemia

“…An improved method for direct quantification of S-TK, based on the use of '25I-lUdR as a substrate, was recently developed by Gronowitz et al 15 Using the improved method, clinical studies have reported elevated S-TK levels in a variety of neoplasias such as breast,16J lung15JS and prostate cancers. 19 s-TK has been found to provide useful therapeutic and prognostic information in a variety hematological disorders such as acute lymphoblastic leukemia,2&22 acute myeloid leukemia,20.2>25 chronic lymphmytic leukemia,2627 non-Hodgkm's lymphorna,2%33 Hodgkm's disease3 and multiple rnyeloma,3538 as reviewed by Hallek et aZ.…”

Deoxythymidine kinase in the staging of prostatic adenocarcinoma

“…Many enzymes involved in DNA replication increase when the malignant cells enter the S-phase and one of these is deoxythymidine kinase (dTK), which catalyses the phosphorylation of deoxythymidine to deoxythymidine monophosphate. Serum dTK levels are elevated during tissue regeneration, embryonal development, and tumor growth [15-171 and have been demonstrated to have prognostic sigruficance in patients with different types of lymphoma and small-cell lung cancer [18,19]. dTK is widely accepted as a proliferation marker and is thought to reflect the aggressivity and growth dynamics of a malignant lesion.…”