Mucins CA 125, CA 19.9, CA 15.3 and TAG-72.3 as Tumor Markers in Patients with Lung Cancer: Comparison with CYFRA 21-1, CEA, SCC and NSE

Purpose Although serum tumor markers (STMs) are widely used in clinical practice, their predictive role for the response to anticancer treatment is still controversial. The correlation of CEA, CA 15.3, CA 19.9, CA 125 (only with peritoneal involvement) and NSE levels with imaging response and clinical benefit was investigated in 60 non-selected patients with metastatic epithelial cancers treated by single-agent docetaxel chemotherapy. Methods STM measurement was performed at baseline and subsequently every three to four weeks. We applied the WHO criteria to evaluate both STM and instrumental responses. Concordance analysis was performed by the Cohen Kw index, and the significance of the results was established using the Fleiss, Cohen & Everitt test. Qualitative interpretation of data was obtained with the Landis & Koch scale. Correlations of STM response with clinical benefit (PS or pain improvement) were evaluated by the chi-square test. Results The primary tumors included breast cancers (38 patients), gastrointestinal non-colorectal cancers (12 patients), and lung cancers (10 patients). An overall significant good degree of agreement was observed between STM and instrumental response (p<0.0005). The degree of agreement for each marker was as follows: excellent for CEA (p<0.0005) and CA 125 (p=0.006), good for CA 15.3 (p<0.0005) and CA 19.9 (p=0.011). Restricted analysis for the correlation of each marker with primary tumor origin showed good prediction of radiological response for CA 15.3 and CEA in breast cancer patients (p<0.0005 for both), for CEA and CA 19.9 in gastrointestinal cancer patients (p=0.01 and 0.04, respectively), and for CEA+NSE in lung cancer patients (p=0.01). Conversely, STM response did not correlate significantly with the clinical benefit for the patients, both in terms of PS and pain improvement (p=0.24 and p=0.42, respectively). Conclusion This study showed STMs to be good predictors of tumor response. Although STMs cannot replace diagnostic imaging, in metastatic cancer they might be useful to optimize the timing of radiological re-evaluation in the palliative setting.

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Valor diagnóstico de la combinación de nueve marcadores tumorales en neoplasias

QhaliKay Revista de Ciencias de la Salud ISSN 2588-0608 ◽

10.33936/qkrcs.v1i1.123 ◽

2017 ◽

Vol 1 (1) ◽

pp. 19

Author(s):

Ivón Howland Álvarez ◽

Yolanda Cruz Gómez ◽

Nairobi Fonseca Torres ◽

Bárbara Dinorah Hidalgo Martínez ◽

Viorkis Pérez Ortiz ◽

...

Keyword(s):

Tumor Markers ◽

Predictive Value ◽

Clinical Laboratory ◽

Reference Value ◽

Ca 125 ◽

Cytokeratin 19 ◽

Neoplastic Disease ◽

Ca 15.3 ◽

Ca 19.9 ◽

Marcadores Tumorales

Muchos marcadores tumorales (MT) no son específicos a un tipo particular de cáncer y el nivel de uno de ellos puede aumentar como consecuencia de más de un tipo de cáncer, por lo que se utilizan en combinación para lograr mayor efectividad diagnóstica. Este trabajo se propone evaluar el valor diagnóstico de la combinación de nueve MT utilizados en diagnóstico de neoplasia tanto de forma individual como combinados. Se realizó un estudio retrospectivo entre enero 2013 y mayo de 2015 en el Laboratorio Clínico del Centro de Investigaciones Médico Quirúrgicas de La Habana a 100 pacientes con diagnóstico de cáncer o sospecha clínica de neoplasia oculta a quienes se les determinaron los marcadores tumorales: antígeno carbohidrato (CA) 19.9, CA 72.4, CA 125, CA 15.3, antígeno carcinoembrionario (CEA), componente de la citoqueratina 19 (Cyfra 21-1), gonadotropina coriónica (HCG), ferritina y antígeno prostático de superficie (PSA). En todos los MT se observó un incremento del valor de corte sobre el valor límite superior de referencia mayor al 8%. En conjunto, la sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo fueron de 23%, 99%, 96% y 51%, respectivamente. Para un valor de corte de 50 la especificidad y el VPP aumentaron a 99,6% y 97,5%, respectivamente. El uso de los 9 marcadores tumorales en conjunto mostró ser útil en el proceso de diagnóstico de pacientes con enfermedad neoplásica. Palabras clave: marcadores tumorales, CA 19.9, CA 72.4, CA 125, CA 15.3, CEA, Cyfra 21-1, HCG, Ferritina y PSA Abstract: Many tumor markers are not specific to a particular type of cancer and the level of one of them may increase as a result of more than one type of cancer, that’s why they are used in combination to achieve greater diagnostic effectiveness. This work aims to evaluate the diagnostic value of the combination of nine tumor markers commonly used in diagnosis of neoplasia both individually and in combination. A retrospective study from January 2013 to May 2015 was conducted at the Clinical Laboratory of the Center for Medical and Surgical Research in Havana, in 100 patients with cancer diagnosis or clinical suspicion of occult malignancy and to whom carbohydrate antigen (CA) 19.9, 72.4, CA 125, CA 15.3, carcinoembryonic antigen (CEA), component cytokeratin 19 (CYFRA 21-1), chorionic gonadotropin (HCG), ferritin and prostate surface antigen (PSA) tumor markers were identified. An increase of cutoff value above the upper limit reference value in all higher TM 8% was observed. Overall, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value were 23 %, 99 %, 96 % and 51 %, respectively. For a cut value of 50 specificity and PPV, they increased to 99.6% and 97.5%, respectively. The use of 9 tumor markers together showed to be useful in the process of diagnosing patients with neoplastic disease. Key words: tumor markers, CA 19.9, CA 72.4, CA 125, CA 15.3, CEA, Cyfra 21-1, HCG, Ferritina and PSA.

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Valor diagnóstico de la combinación de nueve marcadores tumorales en neoplasias

QhaliKay Revista de Ciencias de la Salud ISSN 2588-0608 ◽

10.33936/qhalikay.v1i1.123 ◽

2017 ◽

Vol 1 (1) ◽

pp. 19

Author(s):

Ivón Howland Álvarez ◽

Yolanda Cruz Gómez ◽

Nairobi Fonseca Torres ◽

Bárbara Dinorah Hidalgo Martínez ◽

Viorkis Pérez Ortiz ◽

...

Keyword(s):

Tumor Markers ◽

Predictive Value ◽

Clinical Laboratory ◽

Reference Value ◽

Ca 125 ◽

Cytokeratin 19 ◽

Neoplastic Disease ◽

Ca 15.3 ◽

Ca 19.9 ◽

Marcadores Tumorales

Muchos marcadores tumorales (MT) no son específicos a un tipo particular de cáncer y el nivel de uno de ellos puede aumentar como consecuencia de más de un tipo de cáncer, por lo que se utilizan en combinación para lograr mayor efectividad diagnóstica. Este trabajo se propone evaluar el valor diagnóstico de la combinación de nueve MT utilizados en diagnóstico de neoplasia tanto de forma individual como combinados. Se realizó un estudio retrospectivo entre enero 2013 y mayo de 2015 en el Laboratorio Clínico del Centro de Investigaciones Médico Quirúrgicas de La Habana a 100 pacientes con diagnóstico de cáncer o sospecha clínica de neoplasia oculta a quienes se les determinaron los marcadores tumorales: antígeno carbohidrato (CA) 19.9, CA 72.4, CA 125, CA 15.3, antígeno carcinoembrionario (CEA), componente de la citoqueratina 19 (Cyfra 21-1), gonadotropina coriónica (HCG), ferritina y antígeno prostático de superficie (PSA). En todos los MT se observó un incremento del valor de corte sobre el valor límite superior de referencia mayor al 8%. En conjunto, la sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo fueron de 23%, 99%, 96% y 51%, respectivamente. Para un valor de corte de 50 la especificidad y el VPP aumentaron a 99,6% y 97,5%, respectivamente. El uso de los 9 marcadores tumorales en conjunto mostró ser útil en el proceso de diagnóstico de pacientes con enfermedad neoplásica. Palabras clave: marcadores tumorales, CA 19.9, CA 72.4, CA 125, CA 15.3, CEA, Cyfra 21-1, HCG, Ferritina y PSA Abstract: Many tumor markers are not specific to a particular type of cancer and the level of one of them may increase as a result of more than one type of cancer, that’s why they are used in combination to achieve greater diagnostic effectiveness. This work aims to evaluate the diagnostic value of the combination of nine tumor markers commonly used in diagnosis of neoplasia both individually and in combination. A retrospective study from January 2013 to May 2015 was conducted at the Clinical Laboratory of the Center for Medical and Surgical Research in Havana, in 100 patients with cancer diagnosis or clinical suspicion of occult malignancy and to whom carbohydrate antigen (CA) 19.9, 72.4, CA 125, CA 15.3, carcinoembryonic antigen (CEA), component cytokeratin 19 (CYFRA 21-1), chorionic gonadotropin (HCG), ferritin and prostate surface antigen (PSA) tumor markers were identified. An increase of cutoff value above the upper limit reference value in all higher TM 8% was observed. Overall, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value were 23 %, 99 %, 96 % and 51 %, respectively. For a cut value of 50 specificity and PPV, they increased to 99.6% and 97.5%, respectively. The use of 9 tumor markers together showed to be useful in the process of diagnosing patients with neoplastic disease. Key words: tumor markers, CA 19.9, CA 72.4, CA 125, CA 15.3, CEA, Cyfra 21-1, HCG, Ferritina and PSA.

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Analytical Performance of Ca 19.9, Ca 125 and Ca 15.3 Assays as Observed through an External Quality Assessment Program

The International Journal of Biological Markers ◽

10.1177/172460089400900109 ◽

1994 ◽

Vol 9 (1) ◽

pp. 43-47 ◽

Cited By ~ 5

Author(s):

G.C. Zucchelli ◽

A. Pilo ◽

M.R. Chiesa ◽

S. Masini ◽

A. Clerico

Keyword(s):

Monoclonal Antibody ◽

Quality Control ◽

Quality Assessment ◽

External Quality Assessment ◽

Ca 125 ◽

External Quality ◽

Ca 15.3 ◽

Assessment Program ◽

Ca 19.9 ◽

Control Samples

Immunoassays of the tumor markers CA 19.9, CA125 and CA 15.3 are generally acknowledged to be a useful tool in the management of cancer patients. As a consequence, many methods developed by different companies are now commercially available. However, discrepancies have been described in the results of marker determinations even when the same monoclonal antibody was used. An external quality assessment (EQA) was carried out; starting from 1989 about 110 laboratories participated; since December 1991 the program was linked with the interlaboratory program Oncocheck organized by the Service de Radiopharmacie et Radioanalyse, University of Lyon. At present more than 200 laboratories of many European countries are involved: cumulatively 47 quality control samples have been prepared and sent to the participants. This manuscript is a report on data collected for CA 19.9, CA 125, and CA 15.3.

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Tumor markers (CEA, CA 125, CYFRA 21.1, SCC and NSE) in non small cell lung cancer (NSCLC) patients as an aid in histological diagnosis and prognosis: Comparison with the main clinical and pathological prognostic factors

Lung Cancer ◽

10.1016/s0169-5002(00)80662-5 ◽

2000 ◽

Vol 29 (1) ◽

pp. 195

Author(s):

N Vinolas ◽

R Molina ◽

R Fuentes ◽

I Bover ◽

J Rifa ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Factors ◽

Small Cell Lung Cancer ◽

Tumor Markers ◽

Cell Lung Cancer ◽

Small Cell ◽

Ca 125 ◽

Small Cell Lung ◽

Diagnosis And Prognosis ◽

Nsclc Patients

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Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer Diagnosis

Disease Markers ◽

10.1155/2020/4716793 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Zhineng Wen ◽

Ying Huang ◽

Zhougui Ling ◽

Jifei Chen ◽

Xiaomou Wei ◽

...

Keyword(s):

Lung Cancer ◽

Tumor Markers ◽

Cell Lung Cancer ◽

Area Under The Curve ◽

Nonsmall Cell Lung Cancer ◽

Diagnostic Value ◽

Carbohydrate Antigen ◽

Ca 125 ◽

Chi Square ◽

Diagnostic Efficacy

Background. Lung cancer (LC) is top-ranked in cancer incidence and is the leading cause of cancer death globally. Combining serum biomarkers can improve the accuracy of LC diagnosis. The identification of the best potential combination of traditional tumor markers is essential for LC diagnosis. Patients and Methods. Blood samples were collected from 132 LC cases and 118 benign lung disease (BLD) controls. The expression levels of ten serum tumor markers (CYFR21, CEA, NSE, SCC, CA15-3, CA 19-9, CA 125, CA50, CA242, and CA724) were assayed, and that the expression in the levels of tumor markers were evaluated, isolated, and combined in different patients. The performance of the biomarkers was analyzed by receiver operating characteristic (ROC) analyses, and the difference between combinations of biomarkers was compared by Chi-square ( χ 2 ) tests. Results. As single markers, CYFR21 and CEA showed good diagnostic efficacy for nonsmall cell lung cancer (NSCLC) patients, while NSE and CEA were the most sensitive in the diagnosis of small cell lung cancer (SCLC). The area under the curve (AUC) value was 0.854 for the panel of four biomarkers (CYFR21, CEA, NSE, and SCC), 0.875 for the panel of six biomarkers (CYFR21, CEA, NSE, SCC, CA125, and CA15-3), and 0.884 for the panel of ten markers (CYFR21, CEA, NSE, SCC, CA125, CA15-3, CA19-9, CA50, CA242, and CA724). With a higher sensitivity and negative predictive value (NPV), the diagnostic accuracy of the three panels was better than that of any single biomarker, but there were no statistically significant differences among them (all P values > 0.05). However, the panel of six carbohydrate antigen (CA) biomarkers (CA125, CA15-3, CA19-9, CA50, CA242, and CA724) showed a lower diagnostic value (AUC: 0.776, sensitivity: 59.8%, specificity: 73.0%, and NPV: 60.4%) than the three panels ( P value < 0.05). The performance was similar even when analyzed individually by LC subtypes. Conclusion. The biomarkers isolated are elevated for different types of lung cancer, and the panel of CYFR21, CEA, NSE, and SCC seems to be a promising serum biomarker for the diagnosis of lung cancer, while the combination with carbohydrate antigen markers does not improve the diagnostic efficacy.

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Parameters of Blood Count and Tumor Markers in Patients with Borderline Ovarian Tumors: A Retrospective Analysis and Relation to Staging

ISRN Oncology ◽

10.5402/2012/947831 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Rosekeila Simões Nomelini ◽

Taísa Morete da Silva ◽

Beatriz Martins Tavares Murta ◽

Eddie Fernando Candido Murta

Keyword(s):

Tumor Markers ◽

Blood Count ◽

Ovarian Tumors ◽

Ca 125 ◽

Borderline Ovarian Tumor ◽

Tumor Type ◽

Borderline Ovarian Tumors ◽

Stage Ib ◽

Ca 19.9 ◽

Stage Ia

The aim of this paper was to evaluate the parameters of blood count and tumor markers in borderline ovarian tumors. We evaluated 21 patients who had confirmed histopathologic diagnosis of borderline ovarian tumor. We recorded age, parity, tumor type, stage of cancer, serum levels of tumor markers (CA-125, CA-15.3, CA-19.9, CEA, AFP), and the parameters of blood count, fasting glucose, disease-free survival and overall. The patients were divided into two groups, stage IA (n=13) and stage IB-IIIC (n=8). The unpaired t-test and Fisher's exact test were used, with P values of less than 0.05 being considered to indicate statistical significance. Levels of red blood cells, hematocrit, and hemoglobin were significantly higher in stage IA when compared with stage IB-IIIC (P<0.05). The levels of tumor marker CEA had a tendency to be higher in the group stage IB-IIIC (0.08). Abnormal levels of CEA and CA-19.9 were found more frequently in stages IB-IIIC. Therefore, parameters of blood count, CEA, and CA-19.9 should be targeted for further research in identifying prognostic factors in borderline tumors.

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