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[A clinical evaluation of the versatility of various tumor markers in diagnosing the primary carcinoma of the lung].

In this study, the author has evaluated the diagnostic versatility of the neuron specific enolase (NSE), carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), and serum antigens (KA 32, KA 93) which are detected by anti-human lung carcinoma monoclonal antibodies (KM 32, KM 93) in patients before initiating any treatment. The positive rates of the serum NSE, CEA, TPA, KA 32 and KA 93 in all patients suffering from lung carcinoma were 31.4% (32/102), 52.8% (56/106), 63.3% (62/98), 52% (13/25) and 20% (24/120) respectively. Serum NSE was positive in 80.8% (21/26) of patients suffering from small cell type lung carcinoma (SCLC) and the mean value (32.7 +/- 25.4 ng/ml) was significantly higher than those of other varieties of lung carcinoma. The positive rate of serum CEA in adenocarcinoma (70.2%) was significantly higher than those of squamous cell carcinoma (22.2%). There was no significant statistical difference in positive rates of TPA in various histological types of lung carcinoma. The NSE and CEA were 44.0% (22/50) and 70.6% (36/51) in the stage IV disease and they appeared to reflect the progress and extent of the disease. The TPA tended to show a positive rate even at the initial stage of the disease, but, it was noteworthy that this disclosed a relatively high false positive rate of 54.2% (13/24). Moreover, determination of the serum NSE was performed chronologically. A lowered serum NSE value was confirmed in all cases which responded to the therapeutic attempts and unchanged values or even elevated values were noted in cases which showed no favourable response or rapid progression of the disease. It was also noteworthy that the serum NSE elevation was found 2-6 weeks prior to the clinical confirmation of the recurrence of the tumor in three patients suffering from SCLC. Based on these observations, it is suggested that the serum NSE may serve as a versatile tumor marker in monitoring the stage of disease, effectiveness of the therapeutic attempts and prediction of the possibility of the recurrence in SCLC. However, in view of the fact that some of the cases that obviously demonstrated clinical evidence of tumor recurrence failed to show elevation of the NSE, caution should be exercised in evaluating the alteration of the positive rates. The monoclonal antibody that works against human lung squamous cell carcinoma (KM 32) and antibody that works against human lung adenocarcinoma (KM 93) were isolated and purified.(ABSTRACT TRUNCATED AT 400 WORDS)