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Carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) in the diagnosis of oat-cell and non-oat-cell bronchial carcinoma
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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 guideline criterion for a significant change for determination of tumor response to chemotherapy, although 41% of 22 patients with stable disease exceeded the pretreatment level by 36% or more in either direction (mean percent change + or - standard deviation, -4.1% + or - 52.2%), and 4 of 9 patients with progressive disease did not have levels greater than 36% above the baseline levels. Distribution and Prognostic Value of CEA and T P A 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 antigen (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. Relationship studies between serum CEA positivity and/or serum TPA positivity and survival 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, Medizinische 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 patients with oat-cell and non-oat-cell bronchial 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 concentration of TPA in the case of this carcinoma type was significantly higher than that of the non-oat-cell bronchial carcinoma (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 clinically, and therapeutic measures remained unsuccessful. Contrary to the results of other authors, CEA showed no corresponding alteration in concentration dependent on alternation in phase. CEA-Determinations in Small-Cell Bronchial Carcinoma: Contribution t o Diagnostic Differentiation 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 s m a l l cell bronchial carcinoma. Further deliberations, however, led us to conclude that the clinical relevance of these observations is rather negligible. Anticerebellar Antibodies in Serum and Cerebrospinal Fluid of a Patient with Oat Cell Carcinoma of the Lung and Paraneoplastic Cerebellar 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. Antibodies to cerebellar Purkinje cells and granule cells were detected in both serum and cerebrospinal 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 slightly with plasmapheresis, corticosteroids, and therapy of his underlying tumor, but he continued 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 Concentrations in Bronchoalveolar Lavage Fluids and in the Culture Medium of a Bronchial Carcinoma Cell Line. Schultek, Th., Wiessmann, K.-J., Borisch, B. et al. Klinik ffir Innere Medizin, Medizinische 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 immunoassay in bronchial lavage fluids from 15 patients with chronic bronchitis and 15 patients with histologically confirmed bronchial carcinoma. The TPA concentration in the bronchial lavage from the tumour patients (median 9100 U/l, 16 percentile 2105 U/l, 84
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 guideline criterion for a significant change for determination of tumor response to chemotherapy, although 41% of 22 patients with stable disease exceeded the pretreatment level by 36% or more in either direction (mean percent change + or - standard deviation, -4.1% + or - 52.2%), and 4 of 9 patients with progressive disease did not have levels greater than 36% above the baseline levels. Distribution and Prognostic Value of CEA and T P A 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 antigen (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. Relationship studies between serum CEA positivity and/or serum TPA positivity and survival 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, Medizinische 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 patients with oat-cell and non-oat-cell bronchial 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 concentration of TPA in the case of this carcinoma type was significantly higher than that of the non-oat-cell bronchial carcinoma (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 clinically, and therapeutic measures remained unsuccessful. Contrary to the results of other authors, CEA showed no corresponding alteration in concentration dependent on alternation in phase. CEA-Determinations in Small-Cell Bronchial Carcinoma: Contribution t o Diagnostic Differentiation 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 s m a l l cell bronchial carcinoma. Further deliberations, however, led us to conclude that the clinical relevance of these observations is rather negligible. Anticerebellar Antibodies in Serum and Cerebrospinal Fluid of a Patient with Oat Cell Carcinoma of the Lung and Paraneoplastic Cerebellar 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. Antibodies to cerebellar Purkinje cells and granule cells were detected in both serum and cerebrospinal 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 slightly with plasmapheresis, corticosteroids, and therapy of his underlying tumor, but he continued 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 Concentrations in Bronchoalveolar Lavage Fluids and in the Culture Medium of a Bronchial Carcinoma Cell Line. Schultek, Th., Wiessmann, K.-J., Borisch, B. et al. Klinik ffir Innere Medizin, Medizinische 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 immunoassay in bronchial lavage fluids from 15 patients with chronic bronchitis and 15 patients with histologically confirmed bronchial carcinoma. The TPA concentration in the bronchial lavage from the tumour patients (median 9100 U/l, 16 percentile 2105 U/l, 84