263

nine patients with progressive disease, the CEA levels increased after chemotherapy. Therefore, an increase of greater than 36% beyond the baseline level was a useful gui- deline criterion for a significant change for determination of tumor response to che- motherapy, although 41% of 22 patients with stable disease exceeded the pretreatment level by 36% or more in either direction (mean percent change + or - standard devia- tion, -4.1% + or - 52.2%), and 4 of 9 pa- tients with progressive disease did not have levels greater than 36% above the baseline levels.

Distribution and Prognostic Value of CEA and TPA in Lung Cancer. Leonardo, E., Dogliotti, C., Mancuso, M. et al. Universita di Torino, Istituto di Anatomia e Istologia Patologica, Torino, Italy. Minerva. Med. 77: 375-379, 1986.

Serum levels of carcinoembyonic anti- gen (CEA) and tissue polypeptide antigen (TPA) were investigated in 53 lung cancer patients. The higher percentage of patients with serum CEA positivity was observed within the anaplastic lung cancer group. TPA serum positiVlty was found in a similar percentage in all the examined groups. Re- lationship studies between serum CEA posi- tivity and/or serum TPA positivity and sur- vival were then carried out.

Carcinoembryonic Antigen (CEA) and Tissue Polypeptide Antigen (TPA) in the Diagnosis of Oat-Cell and Non-0at-Cell Bronchial Carcinoma. Schultek, Th., Wiessmann, K.J., Braun, J. et al. Klinik ffir Innere Medizin, Medizinis- che Universit~t zu Lfxbeck, L~beck, Germany. Prax. Klin. Pneumol. 39: 962-966, 1985.

CEA abd TPA serum concentration in the tumor phases 'limited disease' and 'extensive disease' were examined in pati- ents with oat-cell and non-oat-cell bronchi- al carcinoma. In the 'limited disease' group a TPA median of 76 U/1 was determined, CEA at 2.75 mug/l. These concentrations do not differ significantly from the normal, healthy patients. Patients with 'extensive disease', on the other hand, revealed significantly raised concentrations (TPA median 458 U/l, CEA median 18 mug/l) of these tumor markers. In accordance with the biological behavior of oat-cell bronchial carcinoma, the con- centration of TPA in the case of this car- cinoma type was significantly higher than that of the non-oat-cell bronchial carci- noma (median for oat-cell carcinoma = 519 U/1, for non-oat-cell carcinoma 345 U/1). If, in the follow-up, the TPA of individual patients showed an increase by a factor of 2 in the case of non-oat-cell bronchial carcinoma or by a factor of 3 in the case

of oat-cell bronchial carcinoma, then tumor

progression was always to be found clinical-

ly, and therapeutic measures remained unsuc- cessful. Contrary to the results of other authors, CEA showed no corresponding altera- tion in concentration dependent on alternation in phase.

CEA-Determinations in Small-Cell Bronchial Carcinoma: Contribution t o Diagnostic Diffe- rentiation and TheFapy Control? Krischke, w., Niederle, N., Schutte, J. et al. Innere Klinik Tumorforschung, Klinikum der GHS, D-4300 Essen; Germany. Prax. Klin. Pneumol. 39: 823, 1985.

Our study confirmed certain relations between CEA serum concentrations and staging, prognosis, success of therapy and relapse in a fairly large group of patients with small- cell bronchial carcinoma. Further delibera- tions, however, led us to conclude that the clinical relevance of these observations is rather negligible.

Anticerebellar Antibodies in Serum and Cere- brospinal Fluid of a Patient with Oat Cell Carcinoma of the Lung and Paraneoplastic Ce- rebellar Degeneration. Greenlee, J.E., Lipton, H.L. Department of Neurology, University of Virginia Medical Center, Charlottesville, VA 22908, U.S.A. Ann. Neurol. 19: 82-85, 1986.

A 56-year-old man was seen with subacute cerebellar degeneration and was found to have oat cell carcinoma of the lung. Antibo- dies to cerebellar Purkinje cells and granule cells were detected in both serum and cerebro- spinal fluid (CSF), and intrathecal antibody synthesis was suggested by serum CSF antibody ratios, CSF IgG index, and CSF IgG synthesis rate. The patient's condition improved slight- ly with plasmapheresis, corticosteroids, and therapy of his underlying tumor, but he con- tinued to exhibit a severe cerebellar deficit until his death more than one year later. Paraneoplastic cerebellar degeneration may be accompanied by synthesis of anticerebellar antibodies, both systemically and within the central nervous system.

Determination of Keratin and TPA Concentra- tions in Bronchoalveolar Lavage Fluids and in the Culture Medium of a Bronchial Carci- noma Cell Line. Schultek, Th., Wiessmann, K.-J., Borisch, B. et al. Klinik ffir Innere Medizin, Medizinis- che Universit~t zu L0beck, D-2400 LCtbeck i, Germany. Arztl. Lab. 32: 24-26, 1986.

Keratin and tissue polypeptide antigen (TPA) concentrations were determined by immu- noassay in bronchial lavage fluids from 15 patients with chronic bronchitis and 15 pa- tients with histologically confirmed bronchi- al carcinoma. The TPA concentration in the bronchial lavage from the tumour patients (median 9100 U/l, 16 percentile 2105 U/l, 84