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40
oxygenated conditions. It is concluded from
these studies that NSE immunoreactivity per
se is an unreliable marker for the SCLC
phenotype.
Neuron-Specific Enolase - A Selective Marker
of the Small-Cell Bronchial Carcinoma.
Lorenz, J., Mai, G.A., Schulz, V. Abteilung
fur Pneumologie, Universitatsklinikum Mainz,
D-6500 Mainz, Germany. Prax. Klin. Pneumol.
40: 100-102, 1986.
Neuron-specific enolase, the dimer of
an isoenzyme of the glycolysis enzyme
enolase, is a marker enzyme of the neuroen-
docrinal cells and is expressed by neuroen-
docrinel tumours and small-cell (or oat
cell) carcinomas. The authors report on ex-
periences with serum determinations of the
neuron-specific enolase using radioimmunoas-
say methods. Patients with small-cell bron-
chial carcinoma have enhanced neuron-
specific enolase (NSE) levels. Neuroen-
docrinal tumours are also associated to
about 50% with elevated NSE serum levels
compared with other solid tumours. It can be
shown that during the first chemotherapy
course the serum level increases markedly
with small-cell bronchial carcinomas fol-
lowed by a decline until the next treatment
cycle is initiated. Due to this dynamic
relationship we can expect that there is
some kind of link with the probable treat-
ment response.
Clinical Value of a Multiple Biomarker Assay
in Patients with Bronchogenic Carcinoma.
Buccheri, G.F., Violante, B., Sartoris, A.M.
et al. Medical Department, A. Carle Hospital
of Chest Diseases, 12100 Cuneo, Italy. Can-
cer 57: 2389-2396, 1986.
In 98 newly diagnosed patients with
histologically proven bronchogenic carcinoma
seen at Cuneo Hospital of Chest Diseases
from July 1983 to December 1984, multiple
biomarker assays were performed. Fifty-nine
cases had more than one carcinoembryonic an-
tigen (CEA) and/or tissue polypeptide an-
tigen (TPA) assay during the course of the
disease, at 3- to 12-weeks interval. A total
of 209 CEA (91 pretreatment), 170 TPA (80
pretreatment), 62 human chorionic
gonadotropin (HCG)-beta subunits and 60 lac-
tate dehydrogenase (LDH) was assayed. In ad-
dition, serum samples were taken from 141
blood donors and their TPA values were used
as a control. The percentages of elevated
values were, respectively, 37%, 52%, 18%,
and 25%. In 85% of the patients at least one
biomarker was found to be higher than nor-
mal. Neither significant differences between
mean biomarker levels in tumors of various
histologic types nor positive intermarker
correlations were found. The number of
patients with elevated CEA, TPA, and LDH
serum levels and their mean values increased
significantly according to the disease ex-
tent. Among evaluated markers TPA showed the
highest accordance to tumor burden. The
raising of two markers was never associated
with stage I-II disease, except in one
patient. Both CEA and TPA concentrations
changed significantly during the course of
the illness in relation to the clinical
status assessment. Abnormal pretreatment
levels of CEA, LDH, and particularly, TPA
were independently and significantly as-
sociated with a poor outcome. Patients with
abnormal levels of TPA and LDH and, to a
lesser degree, TPA and beta-HCG had shorter
survival as compared with patients with high
TPA values, irrespective of the LDH and
beta-HCG levels, although not significantly
so.
Serum Amyloid A in Carcinoma of the Lung.
Benson, M.D., Eyanson, S., Fineberg, N.S.
Department of Medicine, Rheumatology Divi-
sion, Richard L. Roudebush Veterans Ad-
ministration Medical Center, Indianapolis,
IN 46202, U.S.A. Cancer 57: 1783-1787, 1986.
Serum concentrations of serum amyloid A
protein (SAA), peripheral blood lymphocytes
(PBL) mitogenic response to phytohemag-
glutinin (PHA) and Concanavalin A (Con A),
numbers of circulating T- and B-lymphocytes
and length of survival after diagnosis were
measured in 50 patients with cancer of the
lung. SAA levels were significantly elevated
when compared to 50 control subjects
(P<O.O01), but did not correlate with state
of tumor spread at the time of diagnosis.
Mitogenic responses of PBL from the cancer
patients to PHA and Con A were significantly
depressed (P<O.001), but also did not pre-
dict state of metastatic spread. The per-
centage of circulating T-lymphocytes was
also significantly depressed in cancer
patients when compared to controls. In six
patients who survived tumor-free for greater
than 2.5 years, SAA serum concentrations
returned to normal. Statistical analysis
showed a significant correlation between SAA
serum concentrations and PBL mitogenic
response to Con A. In addition, both high