Sputum carcinoembryonic antigen, neuron-specific enolase and cytokeratin fragment 19 levels in lung cancer diagnosis.
OBJECTIVE
The aim of the present study was to examine the impact of sputum carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and cytokeratin fragment 19 (CYFRA 21-1) levels in lung cancer diagnosis and to compare the diagnostic usefulness of sputum assays with that of serum assays.


METHODS
Forty-seven patients with lung cancer and 62 with benign lung disease were studied. Tumour marker levels in sputum (sp.) and serum (ser) were measured by immunoradiometric assays.


RESULTS
Sputum and serum tumour marker levels were significantly higher in lung cancer than in benign disease. When the specificity was 95%, the sensitivity was 57%, 43%, 36%, 30%, 28% and 19%, for spCEA, serCYFRA 21-1, spCYFRA 21-1, serCEA, serNSE, and spNSE, respectively. Bayesian analysis showed that the best predictive values correspond to spCEA and serCYFRA 21-1. The maximum overall gain was obtained in pretest probability of 0.35 for both spCEA and serCYFRA 21-1, with predictive values of 84% and 80% for spCEA and serCYFRA 21-1, respectively.


CONCLUSIONS
Sputum tumour marker levels were no more useful than the serum levels in lung cancer diagnosis. SpCEA offered the best predictive values but these were still not sufficiently satisfactory for spCEA to be proposed for routine use.
Department of Critical Care and Pulmonary Services, Athens Medical School, Evangelismos Hospital, Athens, Greece. jkalomenidis@hotmail.com
Ioannis
I
Kalomenidis
Katerina
K
Dimakou
Androniki
A
Kolintza
Katerina
K
Vlami
Manos
M
Papadakis
Cristina
C
Sotiropoulou
Dora
D
Orphanidou
Charis
C
Roussos
Spyros
S
Papiris
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000032:analysis* / Q000097:blood; D002283:Carcinoma, Bronchogenic / Q000175:diagnosis / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015592:Immunoradiometric Assay; D007633:Keratins / Q000032:analysis* / Q000097:blood; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000032:analysis* / Q000097:blood; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D013183:Sputum / Q000737:chemistry*
D002272:Carcinoembryonic Antigen; D007633:Keratins; D010751:Phosphopyruvate Hydratase