Diagnostic value of serum CYFRA 21-1 in lung cancer

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factor (TNFJ 8. Semiquantitative comperisons between patients’ TIL and PBL and healthy normal and activated PBL were performed by computerized image analysis. RT-FCRgel band products were quantified in relative units as a won of their size and intensity. TIL expressed deteaable lymphokine mRNA but seemed poorly activated with respect to the total number of lymphokine genes and the amount of mRNA compared with -3-activated healthy PBL. IL-2, IFNpamma, and TNF8 did not appear to be expressed at higher levels in TIL than in autologous or healthy normal PBL. However, two-thirds of the patients had TIL distinguishable from autologous PBL by specific expression of GM-CSF and from healthy normal PBL by expression of IL-~. These <s show that lung adenocarcinoma TIL populations had little lymphokine gent a&-&ion despite the pnsare of seveml T cdl subsets expressing different adhesionhctivation markers. The lack or deficient combination of lymphokine production may be a faaor that prevented efRcient activation of TIL in these tumors. Broachoaiveolar Iavage fluid level of carcinoembryonic antigen in the di8gnoris of peripheral lung cancer Sanguinetti CM, Riccioni G, Marchesani F, Pela R, Cecarini L. Divisione di Pneumologia, Ospedale ‘SS Benvenuto e Rocco : bia Leopanii, 1.5, 60027 Osimo (AN). Monaldi Arch Chest Dis 1995;50:177-82. The objective of this study was to verify whether the assay of carcinoembryonic antigen (CEA) in bronchoalveolar lavage fluid (BALF) can increase the sensitivity and specificity of serum CEA for the diagnosis of lung cancer. We examined 72 subjects, 53 males and 19 females, 18 at&&d with peripheral lung cancer (10 adenecarcinoma, 6 squamous eel1 carcinoma, 1 small cell lung cancer, 1 adenosquamous carcinoma), 19 with acute pneumonia, 14 with chronic obstructive pulmonary disease (COPD), 6 with interstitial lung disease (ILD), and 15 healthy subjects. CEA was assayed in blood and in BALF using microparticle eozyme immuooassay (IvfEIA) (IMX Abbott). The mean semm CEA value in the lung cancer group did not differ from that in each group of non-neoplastic subjects, neither was it different from that in healthy subjects. The mean BALF CEA in patients with lung cancer, pneumonia, and CGPD was significantly increased compared with that in healthy subjects, whereas there was no difference between the three groups of patients. The mtio of BALF CEA was not signiticantly &rent in the three groups of patients. There were no differences according to the histological type of the tumour (adenocarcinoma or squamous cell carcinoma). Based on the results in healthy subjects, the upper limits of normal were delined for serum CEA, BALF CEA, and CEA/albumin ratio, Tlms, the sensitivity of BALF CEA in de.tecdng lung cancer (50%) was higher than that ofsenrm CEA (33%). although clinically not useful. In addition, BALF CEA had only 59% specificity compared to 100% of sennn CEA. The diagnostic accuracy was 79% for serum CEA and 56%for BALF CEA. The assay of CEA in bronchoalveolar lavage fluid is slightly mofc sensitive but less specific than serum CEA, and does not seem to be any better than serum CEA in the diagnosis of peripheral lung cancer. Bronchoalveolar Iavage in the diagnosis of low-grade, MALT tyw B-cell lymphoma in the lung Poletti V, Romagna M, Gasponi A, Baruzzi G, Allen KA. Divisione di Pneumologia, Ospedale Maggiom. L.atgo Nigrisoli 2, 40133, Bologna. Monaldi Arch Chest Dis 1995:50: 191-4. Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type represents one of the most frequent primary lymphomas in the lung. This study demonstrates the value of bronchoalveolar lavage (BAL) in the diagnosis of this entity, Tluoe patients with biopsy p&en MALT lymphoma in the lung were submitted to bronchoscopy. BAL fluid analysis showed an increased cellularity and a striking

lymphocytosis. Cytological features consistent with a low-grade malignant lymphomawcre present in two cases (odium sized lymphoid cells with an evident lymphoplasmocytoid differentiation, and irregular nuclear borders), In all QLses, flow cytometry analysis showed a high percentage of cells expressing a B phenotype (52, 40 and 28%, mpeetively). In twu cases, there was a striking monotypic expression of surface light-chain immunoglobulin (Kapm ratio = 38 and 0.04, respectively). Bronchoalveolar lavage appears to be a valuable procedure in the diagnosis of low-grade B-cell lymphoma of MALT type in the lung.

Expression of several biologic markers as prognostic markers in non-small cell lung cancexs Kim SY, Cho HI, Sub JW, Kim NJ, Kim JO. Deparfment of Inremal Medicine, Chungnam National University, School of Medicine, Taejon. lbberc Reapir Dis 1995;42:142-8. Backgmund Despite modem diagnostic, staging, and therapeutic advances, esp. with molecular biologic techniques& 5-year survival rateofallcasesoflungcamrrdoesnotex~15$6.Al~,tbeiacidence 0fhmgcancerofbothsexesinKorcais -YearbyYaand hIrIg cancer is One of the leding causes of cancer death. Thcreforc, it is stronglyneededt0deve1opulenewu&iitionof&atmont modaliues including neoadjuvant chemotherapy and to identiQ tumor specific cbaraaeristics with staging or pmgnostic markers. Here we present the clinical significance of several biologic tumor markers to use as prognostic markers in patients with non-small cell lung cantors. MCthOd: The smvival has unrelated with the expressibility of proliferative cell nuclear antigen (PCNA), epidermal growth factor wr (EGFR), ~53 and/or blood group antigen A (BGAA) using immumhistochanistly in 46 patients with non-small cell lung cancers. Results: (1) The expression rates ofPCNA, EGFR, ~53 and BGAA were 80.6%. 61.3%. 45.9% and 64.3% respecuvely and those wre wt collated to cell types or clinical stages. (2) The expression of BGAA was correlated withbettersunivalinmedianswivalandin2-yearslwivalratt~d thatdPCNAwaswmlatedwithworse~~inmediansunival and 2-year survival rate. (3) The wrpnssion of EGFR or ~53 was not valuable to predict prognosis in non-small cell lung cancers. (4) with simukamous appkatio~~ ofPCNA, EGFR and ~53 immtmosfh. the ~tientswith2ormorrne~ti~ucpresJioasshowedbetter ptugnosis than the patients with 2 or more positive ucpressions. Conclusion: It is suggested that the expression ofblood gmup antigen may be a positive prognostic fauor and that ofFCNA may be a negative progno& factor. Also, the combiion of expressions of PCNA, EGFR and ~53 may be used as a negative pmgnostic factor. Diostic due of serum CYFR4 21-l in hmg cancer YoonHD,KimKD,ChungJH,LccHw,L&KH,LeeHwdal.Dept. ojlnlemal Mealcine, College ofMedicine, Yeungnon Universi&, Taegu. Tuberc Respir Dis 1995;42: 149-55. Background: Cytokeratin 19 is 40KD acidic molecule whose distribution is restricted to simple or wtified epitholia, such as the epithelial layer of the bronchial tree. Immunomcal stwJies have shown that cytokeratin 19 is overexpressed in lung carcinoma tissue. Animmuuoradiomotricassay,CyFRA21-1 hasbeendeveloped using two moncclonal antibodies, BM 19-21 and KS 19-1, reactive to different epitopes on cytokeratin 19. We studied the diagnostic value of CYFIU 21-1 in lung cancer. Method: The serum CYFRA 21-1 level using immunoradiometric kit (ELSA-CYFRA 21-1) was measured in 54 patients who admit to Yeungnam University Hospital from April, 1993 to August, 1994. Lung cancer group was 39 primary lung canczr patients (19 patients with squamous cell carcinom 11 patients with adenodarcinoma and 9 patients with small cell carcinoma). Control

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group was 15 patients with non malignant lung diseases (8 patients with pulmonary tuberculosis, 3 patients with chronic obstructive pulmonary disease, 2 patients with pneumonia and 2 patients with chronic obstructive pulmonary disease combined with pulmonary tukrculosis).Resulls:TbemeansenunvalueofCYFRAZl-Iwas20.2 * 4.7 rig/ml in squamous cell carcinoma, 7.2 f 1.6 nglml in adenocarcinoma and 15.5 l 4.7 ngAnl in non-small cell lung cancer. The saum value 0fCYFRA 21-1 in control group was 1.7 M.5 @ml. All of the serum vahtes of 3 histologic types were signiticantly higher thanthatofcontrolgmup@~O.O1).TheserumvalueofCyFRA21-1 of squamous cell carcinoma was signiticantly higher than that of adermacinoma @ < 0.05). Serum value of CYFRA 21-1 in small cell lung-r was 2.9 * 0.9 rig/ml and not signilicantly different compared with control group. Using cut off value of 3.3 @ml, sensitivity and specilicity was 11. l%, 65.2% in small cell lung cancer, 70.0%. 62.5% in non-small cell lung cancer, 73.7Y* 75Y0 in squamous cell carcinoma and 63.6% 78.9% in adenocarcinoma, mspcctively. Conclusion: The serum levels of CYPM 2 l-1 may be u&id in diagnosis of non-small cell lung carcinoma, especially in squamous cell carcinoma with its high specificity.

Fibembmnchoscopic findings in 246 cases of central type of lung cancer Wang X-Y, Yang J-Q, Zhang G-D. Thnrgshmr 7kmor Ho@tal, Tmgshon. Chin J Clin Gncol 1995;22:467-9. TWO hundred and forty-six patients with central type of lung cancer wxeexamimdwithfibembmdosmpy. Allthenmplasmswere.situated at the level of segmental lobular bronchi and centripetally. 6 1% of the tumors were located in the right lung and 39% on the let?. Upper lobes hosted 46.4% of the lesions and the lower lobes harboured 28% ofthe hunors. Pathologically thtee types wele remthey wen squamous cell carcinoma (56.1%). small cell carcinoma (28%) and adenocarcinoma (14.6Ye). Squamous cell carcinoma usually appeated as exophytic gmvth and tended to block the bronchial lumen. On the other hand, small cell carcinoma and adenocarcinoma were prone to infiltration. Endoscopically the former usually presented as local overgrowth of the mucous membrancc and the bronchial lumen in turn was natmwed; the latter was polypoid in form. And, the discoloration androughncssoftbelocalmucousmembtanceappeaMin12ofthem whose cheat film and CT scan weie negative for signs of-r. It is conch&d that repeated bronchoscopic ucamiaation may improve early diagnosis of the lung -.

Omsomucoid: Prealbumine ratio in lung cancer Charct J.C. Lepretm A. Watins J. Jounieaux V. Amn C. Chamt P Service de pneunwlogie, hopital de Rodeo. I rue Combarel. 12000 Rode; Ann Biol Clin 1995;53:131-4. Lung cancer is a common patbologv wih high mortality rate due to late diagnosis. The 1987 TNM dassitication clearly detines the different steps and their prognosis. Although the prognostic value of some biological pamnuMs (nminly serum LDH, sodium aud/or albumin) has been established. these are not much used. We ahve pmspectively studied the serum levels of seven pmteins (RBP, prenlbumin, albumin, bansferrin, haptogkhin, otosomucoid, CRP) and we demonstrate the predominant value of preaRmnun for the establishment of the prognosis of lung cancer; determination oforosomucoid increases the prognostic value ofprealbumin. We contirm, for lung cancer, the prognostic value of the orosomucoid-prealbumln ratio, already known for other cancers.

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Small peripheral lung carcinoma evabuted with incremental dynamic CT: R8diologic-pathologic correlation YamashitaK,h4atsunobeS,TakahashiR TsudaT,MatsumotoKMiki H et al. Department of RadioIogv. Shiga Health Insurance Hospital, 16-1, Fujimidai, Otsu 520. Radiology 1995;1%:401-8. Purpose: To correlate incremental dynamic computed tomographic (CT) and pathologic findings in peripheral lung -r. Material and Methods: Lung lesions smaller than 3 cm in diameter were evaluated in 18 patients. CT values of the’ inner area of the nodule at plain CT and at 30 seconds, 2 minutes, and 5 minutes af&er administration of nonionic contrast material were calculated with incremental dynamic CT. Maximum attenuation was compared with pathologic type of lung carcinoma and with number of vessels and distribution of elastic fibers in the pathologic specimen. Results: Enhancement of all lesions was statistically sign&ant (P < .OOOl). Maximum attenuation of lung carcinomas correlated positively with number ofsmall vessels (diameter, 0.024.10 mm) (r = .77). Distribution of elastic fibers in the tumoral interstitium correlated with maximum attenuation (P = .04 between grades 1 and 3) and with number of small vessels (P = .Ol between grades l- 3; P = .008 between grades 1 and 3). Conclusion: Enhancement chaNctcritics of lung carcinomas retleet the number of small tumoral vessels and the distribution of elastic fibers in the tumorsJ interstitium. Enzymolinked immunosorbent assay of pro-gastrin-releasing peptide for small cell lung cancer patients in comparison with neuron-specific enolase measurement Yamaguchi K, Aoyagi K, Urakami K, Fukutani T, Maki N, Yamamoto S et al. Growth Factor Division, National Cancer Center. Research Institute, 5-I-l Tsukiji, Chuo-ku, Tokyo IO4. Jpn J Cancer Res 1995;86:698-705. Our previous study demonstrated that pro-gastrin-releasing peptide(3 l-98). or ProGRP, is a specific tumor marker in patients with small cell lung carcinoma (SCLC). Using a newly developed, highly sensitive enzyme-linked inununosorbent assay (ELISA) for ProGRP, we analyzed 1,446 samples including those obtained from 478 lung cancer patients to evaluate the clinical usetidncss ofthis ELISA. Several properties indicated that ProGRP is a useful tumor marker for SCLC. First, ProGRP was specifically elevated in SCLC patients. In non-SCLC patients and patients with non-tumorous lung diseases, its serum level was very rareIy elevated. Secondly, ProGRP was a reliable marker, in terms of the marked elevation of serum PmGRP levels in SCLC patients. Thirdly, serum ProGRF levels were elevated in SCLC patients even at a relatively early stage of this disease. Fourthly, changes in the senun ProGRP level showed an excellent correlation with the therapeutic responses in SCLC patients. Neuron-specific enolase (NSE) is acccptcd as a tumor marker of SCLC patients. W~tb the aim of mmparing ProGRP and NSE as tumor markers for SCLC patients, we measured serum NSE levels in all samples collected in the present study. We found that PKIGRP was superior to NSE in tenns of sensitivity, specificity and reliability. Therefore, we consider that ProGRP can play a major role as a clinical tumor marker for SCLC patients.

Survival of stage I lung cancer p8tients with previous or subsequent primuy 4-t neoplasms Mrsiljev OA, Kartchenko VP, Koozmine IV Moscow Res. inst. of Diagnosis&rg.; Profsojuznaya str. 86, Moscow. Radio1 Oncol 1995;29: 148-52. From1%5to19902161patientsunderwentthecompleteresection for lung cancer. In 910 cases stage I was histologically proved. pT1 375 (41%). pT2 - 532 (58,7%). There were 90.9% cases observed for more then 5 years, 60.2% - 10 years. Ninety-six (10,6%) patients were