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Prognostic value of CEA, NSE and CK-BB in sera of patients kith small cell lung cancer
176s
D-105 PROGNOSTIC VALVE OF CEA, NSE AND CK-BE IN SERA OF PATIENTS WITH SMALL CELL LUNG CANCER. Jaques G., Bepler G., Holle R., Wolf M. and Havemann K. Dept. of Internal Medicine, Div. of Hematology/Oncology, Philipps-University Hospitals, D-3550 Marburg, F.R. Germany The aim of the study was to simultaneously determine carcinoembryonic antigen ICEA), neuronspecific enolase (NSE) and the BB isoenzyme of creatine kinase (CK-BB) levels in sera of pa tients with small cell lung cancer (SCLC) in a prospective fashion prior to treatment to evaluate their usefulness for the clinical management of patients in particular with respect to disease spread, response to therapy and prediction of survival. Marker levels were classified as normal, elevated or pathologic. The markers were tested in 195 patients at diagnosis. Our data show that 1. NSE is elevated or pathologic in 66%, CEA in 44% and CK-BB in 32% of SCLC patients at the time of diagnosis; 2. marker levels do not differ significantly among patients with localized and metastasized tumors without liver or bone marrow involvement; 3. median marker levels are significantly elevated in patients with liver and/or bone marrow involvement which is particularely true for NSE and CK-BB; 4. marker levels can predict response to therapy in patients with liver and/or bone marrow metastases; 5. patients with pathologic NSE and CK-BB levels have significantly shorter median survival than those with normal or elevated levels; 6. among the individual marker levels a correlation was found between NSE and CK-BB, CEA did not correlate with other marker levels. From these data we conclude that CEA has limited clinical applications as a tumor marker for SCLC patients, NSE is the most frequently elevated marker at diagnosis and correlate well with disease spread and has prognostic value of predicting survival, and CK-BB is the marker with the highest correlation for predicting response and survival. D-106 ;;t;;
en receptor associated protein ERD 5 - Relation cancer cytosols s breast F.J;inicke Frauenklinik der TU, Miinchen W.Eiermann Frauenklinik Klinikum Grosshadern, Miinchen
to
hormone
receptor
status
The ERD 5 antigen, a protein localised in the cytoplasma of tumor cells, is detected by a monoclonal antibody raised against partially purified estrogen receptor from human myometrium. The relation of this protein to the hormone receptors in breast cancer cytosols is investigated. Methods: A total of 347 tumor cytosols were chosen from a cytosol bank in order to form equally distributed subgroups of patients according to menopausal status, estrogen and progesterone receptors. In that way, eight subgroups are distinctable: +/-/+ -/pre/post +/+ In all cytosols, ERD 5 was determined using an immunoradiometric assay kit (IRMA,Amersham). Estrogen (ER) and progesterone (PR) receptors were measured by radioligand binding assay using DCC methode. Correlations were analysed according to the methode of Spearman. Results: Concerning the whole group, there was a weak correlation between the levels of ER and -=0.300). This was due mainly to the stronger correlation in the premenopausal groups (R=0.443), especially the subgroup +/+ (R=0.510) than in the postmenopausal groups (R=0.134), where no correlation could be detected. No correlation neither regarding the group as a whole (R=O.OlB)nor in any subgroup could be seen between PR and ERD 5. 79 % of the tumors with ERD 5>10 U/mg protein were rece torpositive (ER and/orPR)lO f mol/mg), while only 31 % of the samples containing ERD 5<1 B U/mg were ER and PR negative. Conclusion: The value of ERD 5 determination and its cut off limits remain to be established in studies observing response to hormonal therapy. D-107 AROYATASE ACTIVITYINNOEMALBIiNIGNANDYALIGNANT HUMANBREAST TISSUE!5 J.c KOUYOUMD.JIAN. F. FEUILHADE. J. EEAUNE.and J.C.RYMER Laboratoire de CancCrologieclinique et
fondamentale de 1’Uoivcrsiti Paris Val de Marne. H6pital Henri Mondor94000 CRETEIL FRANCE Estradiol is the major hormone which support the growth bf breast neoplasms. Recent data suggest that thb steroid may be synthetized in situ by human breast tumors from androstendione via aromatase. HOweVef the clinical significance of this local estradiol production is not yet clearly demonstrated. In u preliminary report Millerhas shown that the determination of e-01 biosynthesis in breast tissue may help select patients for treatment with aminogluthetimide (AG)*. tumors without aromatase activity being unlikely to respond to such therapy. We have shown that benign tumors sometimes contain high level of e-01 and progesterone receptors (ERand PR) comparable ta cancers. But the concentration of aromatase in this benign tumors is not known. In our study we have determined, prior the treatment the level of aroma&se activity in four groups OfWomen. - GROUP1: normal breast&sues - GROUP 2 : benign mastopathies. adenofibrosis and fibrocystic mastosis - GROUP 3 : adenocarcinomes - GROUP 4 : metastatic cell8 mostly from pleural effusions. Simultaneously the level of ERand PRare measured in same samples. Different clinical pa.t%ueters are also determined. such as SBRhktopronoatic grading. Aroma&se activity in samples have been detl rmined. Ourdata show. a groat variation of aroma&se activity level from,sample to sample in each gro IP and also between different groups. In normal cells. the e&radio1biosynthesis is not frequent (l/4). In benign tumors the level of estradiol biosynthesis is also rare but more frequent than in normal cells (4110). In adeno-carcinomas 50 ‘Aof tumors exhibited aromatasa activity. In this group no correlation w(u observedbetween aroma&se activity and receptors status or SBRgmdiig. In groups 3 and 4 some patients are presently treated by AG.A linkage between tumor aromatase and treatment efficiency is frequently observed, (* Orimetene CIDAGEIGY).
D-105 PROGNOSTIC VALVE OF CEA, NSE AND CK-BE IN SERA OF PATIENTS WITH SMALL CELL LUNG CANCER. Jaques G., Bepler G., Holle R., Wolf M. and Havemann K. Dept. of Internal Medicine, Div. of Hematology/Oncology, Philipps-University Hospitals, D-3550 Marburg, F.R. Germany The aim of the study was to simultaneously determine carcinoembryonic antigen ICEA), neuronspecific enolase (NSE) and the BB isoenzyme of creatine kinase (CK-BB) levels in sera of pa tients with small cell lung cancer (SCLC) in a prospective fashion prior to treatment to evaluate their usefulness for the clinical management of patients in particular with respect to disease spread, response to therapy and prediction of survival. Marker levels were classified as normal, elevated or pathologic. The markers were tested in 195 patients at diagnosis. Our data show that 1. NSE is elevated or pathologic in 66%, CEA in 44% and CK-BB in 32% of SCLC patients at the time of diagnosis; 2. marker levels do not differ significantly among patients with localized and metastasized tumors without liver or bone marrow involvement; 3. median marker levels are significantly elevated in patients with liver and/or bone marrow involvement which is particularely true for NSE and CK-BB; 4. marker levels can predict response to therapy in patients with liver and/or bone marrow metastases; 5. patients with pathologic NSE and CK-BB levels have significantly shorter median survival than those with normal or elevated levels; 6. among the individual marker levels a correlation was found between NSE and CK-BB, CEA did not correlate with other marker levels. From these data we conclude that CEA has limited clinical applications as a tumor marker for SCLC patients, NSE is the most frequently elevated marker at diagnosis and correlate well with disease spread and has prognostic value of predicting survival, and CK-BB is the marker with the highest correlation for predicting response and survival. D-106 ;;t;;
en receptor associated protein ERD 5 - Relation cancer cytosols s breast F.J;inicke Frauenklinik der TU, Miinchen W.Eiermann Frauenklinik Klinikum Grosshadern, Miinchen
to
hormone
receptor
status
The ERD 5 antigen, a protein localised in the cytoplasma of tumor cells, is detected by a monoclonal antibody raised against partially purified estrogen receptor from human myometrium. The relation of this protein to the hormone receptors in breast cancer cytosols is investigated. Methods: A total of 347 tumor cytosols were chosen from a cytosol bank in order to form equally distributed subgroups of patients according to menopausal status, estrogen and progesterone receptors. In that way, eight subgroups are distinctable: +/-/+ -/pre/post +/+ In all cytosols, ERD 5 was determined using an immunoradiometric assay kit (IRMA,Amersham). Estrogen (ER) and progesterone (PR) receptors were measured by radioligand binding assay using DCC methode. Correlations were analysed according to the methode of Spearman. Results: Concerning the whole group, there was a weak correlation between the levels of ER and -=0.300). This was due mainly to the stronger correlation in the premenopausal groups (R=0.443), especially the subgroup +/+ (R=0.510) than in the postmenopausal groups (R=0.134), where no correlation could be detected. No correlation neither regarding the group as a whole (R=O.OlB)nor in any subgroup could be seen between PR and ERD 5. 79 % of the tumors with ERD 5>10 U/mg protein were rece torpositive (ER and/orPR)lO f mol/mg), while only 31 % of the samples containing ERD 5<1 B U/mg were ER and PR negative. Conclusion: The value of ERD 5 determination and its cut off limits remain to be established in studies observing response to hormonal therapy. D-107 AROYATASE ACTIVITYINNOEMALBIiNIGNANDYALIGNANT HUMANBREAST TISSUE!5 J.c KOUYOUMD.JIAN. F. FEUILHADE. J. EEAUNE.and J.C.RYMER Laboratoire de CancCrologieclinique et
fondamentale de 1’Uoivcrsiti Paris Val de Marne. H6pital Henri Mondor94000 CRETEIL FRANCE Estradiol is the major hormone which support the growth bf breast neoplasms. Recent data suggest that thb steroid may be synthetized in situ by human breast tumors from androstendione via aromatase. HOweVef the clinical significance of this local estradiol production is not yet clearly demonstrated. In u preliminary report Millerhas shown that the determination of e-01 biosynthesis in breast tissue may help select patients for treatment with aminogluthetimide (AG)*. tumors without aromatase activity being unlikely to respond to such therapy. We have shown that benign tumors sometimes contain high level of e-01 and progesterone receptors (ERand PR) comparable ta cancers. But the concentration of aromatase in this benign tumors is not known. In our study we have determined, prior the treatment the level of aroma&se activity in four groups OfWomen. - GROUP1: normal breast&sues - GROUP 2 : benign mastopathies. adenofibrosis and fibrocystic mastosis - GROUP 3 : adenocarcinomes - GROUP 4 : metastatic cell8 mostly from pleural effusions. Simultaneously the level of ERand PRare measured in same samples. Different clinical pa.t%ueters are also determined. such as SBRhktopronoatic grading. Aroma&se activity in samples have been detl rmined. Ourdata show. a groat variation of aroma&se activity level from,sample to sample in each gro IP and also between different groups. In normal cells. the e&radio1biosynthesis is not frequent (l/4). In benign tumors the level of estradiol biosynthesis is also rare but more frequent than in normal cells (4110). In adeno-carcinomas 50 ‘Aof tumors exhibited aromatasa activity. In this group no correlation w(u observedbetween aroma&se activity and receptors status or SBRgmdiig. In groups 3 and 4 some patients are presently treated by AG.A linkage between tumor aromatase and treatment efficiency is frequently observed, (* Orimetene CIDAGEIGY).