Abstracts/Lung Cancer 14 (19%) 377-408 395

decreased (from 88.8 % to 40%). Nevertheless, the combination of TPA and CA 19-9 showed significantly higher sensitivity in patients with resectable non small cell lung cancer (NSCLC) and limited small cell lung cancer (SCLC) than TPA alone (87 96 vs 49 % and 88.8 % vs 44.4 % respectively) without significant differences in specificity. The relative possibility of lung cancer was 15% when one tumor marker was positive. This possibility increased to 82%-100% when more than three markers were positive.

The presentation of primary bronchial adenocarcinoma and the evolution observed in a pneumology service over an 11 year period Jeanfaivre T, Vielle B, Montane J, Tuchais E. Service de Pneumologie, CHU, F-49033 Angers Ceder 01. Rev Ma1 Respir 1995;12:365-9.

The evolution of the clinical presentation, endoscopy and radiology inaconsecutiveseriesof 121 casesofprimary bronchialadenocarcinoma has been studied in a retrospective manner over a period of 11 years. The mean age was 60 + 12 and 16.5% of the patients were women. The frequency of smoking and the quantity smoked in packed years was significantly higher in men than in women. The frequency of the presenting signs and the endoscopic features did not change over the period. On the other hand, the peripheral and mediastino-hilar forms were more frequent from 1990 in a significant manner so that the hilar form became rarer. The result seems to confirm an increase in the frequency of a new radioclinical expression of primary bronchial adenocarcinoma. These mediastino-hilaradenocarcinomas do not have specific characteristics hut are associated with a higher mortality.

The usefulness of Vc-tetrofosmin in the diagnosis of lung tumors. A preliminary assessment Novoa N, Tabuenca MJ, Varela A, Mar Cordoba M, Ortiz Berrocal JL, Montz R. Servicio Cirugin Toracico Cardiovasc. Modrid. Arch Bronconeumol 1995;31:410-4.

We conducted a preliminary study of captation of the new radio- pharmaceutical ““Tc-tetrofosmin in cases of primary carcinoma of the lung, analyzing the results of 5 cases studied before surgery with single photon emission tomography (SPECT) of the lung. The results obtained by imaging were compared with those from surgery. Tumor size ranged between 3.5 and 9 cm. In all cases the images showed that captation of the radiotracer by the neoplasm was satisfactory, leaving the area of the tumor clearly distinguishable from normal adjacent lung tissue and giving no signs of interference caused by absorption of W”Tc-tetrofosmin by contiguous structures (heart or liver). Based on these preliminary results we assert that SPECT of the lung using wTc-tetrofosmin may be useful in the clinical diagnosis of malignant lung tumors, although further research must determine to what extent the technique can be relied upon.

The value of tumor markers in the diagnosis, staging and prognosis of lung cancer Khalifa A, Hassan MI, Hamza MR, El-Morsi B, El-Ahmady 0, Abdel Aziz IO. Oncology Diagnostic Unit, Biochemistry Department. Ain Shnms Faculty of Medicine, Cairo. Cancer Mel Biol 1995;2:541-7.

The population studied in this work were 40 freshly diagnosed cases of bronchogenic carcinoma, their ages ranged behveen 35 and 75 years. Fifteen patients had metastatic disease. Carcinoembryonic antigen (CEA). Neuron specific enolase (NSE), B,-microglobulin (B,-MG) and Calcitonin were measured in patients sera before, 3 and 24 weeks after initiation of therapy. The results of this study demonstrated a diagnostic sensitivity of CEA, NSE, 8,-MG and Calcitonin of 85 %, 52.5 %, 55 %, and 32.5%. respectively. NSE and calcitonin showed a statistically

significant increase in small cell carcinoma (SCLC) and non-small cell lung cancer (NSCLC) patients. The mean values of CEA, NSE and R,- MG in sera of patients with metastases were higher as compared to those without m&stases. CEA and NSE proved to be useful markers in monitoring response to therapy as evidenced by a positive correlation between the marker levels and the clinical response. Calcitonin was the only marker studied which showed a correlation with the pathological grading. 8,microglobulin was the least sensitive of the markers studied depending on the data obtained in this study. Taken altogether, the diagnostic sensitivity of these. markers was much improved in a multiparametric analysis protocols.

CEA, CYFRAZl-1 and SCC in non-small cell lung cancer More D, Villemain D, Vuillez JP, Agnius-Delord C, Brambilla C. Department of Respiratory Medicine. Hopital A. Michallon, BP 217X, 38043 Grenoble Ceder 9. Lung Cancer (Ireland) 1995; 13: 169-76.

CEA, SCC and CYFRA 21-1 were measured in samples of serum coming from 105 ‘Non small cell lung cancer’ (NSCLC) patients. The present study has been carried out to compare these markers, to analyse their prognostic significance and to determine the best combination of tumor markers. The median valueand interquartile range were: CYFRA 21-1: 2.3 nglml, CEA: 3,7 rig/ml, SCC: 1,2 nglml. CEAdemonstrated higher values in adenocarcinomas (P = 0.04). SCC and CYFRA 21-1 were comparable in the different histologic groups. CYFRA 21-1 and CEA values were dependant on tumor stage. Advanced tumors (T3 and T4) demonstrated higher serum CYFRA 21-1 level (P = 0.0006). CYFRA 21-1 was higher than 3,3 nglml in 36 % of patients. CEA was higher than 5 rig/ml in 38 $6 of patients and SCC was higher than 2 ngl ml in27 46 ofpatients. Patientswitha high CEAand CYFRAZI-I serum level had a shorter survival than those with a normal serum level. In a Cox regression analysis four variables (TNM stage, age, CYFRA 21- I and CEA level) were found to be significant in the prediction of survival; CYFRA 21-1 level had the lowest P value (P = 0.0002). The current study suggests the use of a combination of CEA and CYFRA 2 l- 1 in the clinical care of NSCLC.

Monitoring lung cancer with tissue polypeptide antigen: An ancillary, profitable serum test to evaluate treatment response and posttreatment disease status Buccheri G, Ferrigno D. Via Repubblica IO/c. I-12018 Roccavione (CA’). Lung Cancer (Ireland) 1995;13:155-68.

The tissue polypeptide antigen (TPA) is a protein produced and released by proliferating cells that possesses several characteristics for an ideal tumor marker. Our purpose was to define the clinical yield of TPA in the follow-up of patients with lung cancer (LC). Three hundred and forty-one new LC patients under vent an extensive pre-treatment staging evaluation (UICC I 1987 classification) and a TPA serum measurement. We restaged them at regular times by: 1, clinical history and physical examination, routine lab tests, chest X-rays, and any other examination as suggested by the prior baseline evaluation, and 2, the serumlevelofTPA. Weevaluatedatotalof 1513 assays(including 1172 posttreatment measurements). Individual values of TPA correlated significantly with treatment response and disease status. Patients with small-cell lung cancer showed the lowest correlation indexes behveen clinical parameters and the marker. Each objectiveresponse to treatment or disease progression was almost always associated to consistent changes ofTPA (P < 0.0001, by the Wilcoxon’s test). A50% reduction under the prior TPA value was 30% sensitive, 90% specific, and 88 % accurate in the diagnosis of response to treatment. The same percent reduction was 18% sensitive, 92% specific, and 88% accurate in predicting a future response. A 100% increase over the prior level of TPA permitted to recognize tumor relapses with sensitivity, specificity.