title: The Diagnostic and Prognostic Value of Tumor Markers (CEA, SCC, CYFRA 21-1, TPS) in Head and Neck Cancer Patients.
abstract: OBJECTIVE
  Establishing prognostic factors is very important in the management of cancer patients. Our aim was to evaluate the clinical significance of a panel of tumor markers, including CEA (Carcino Embryonic Antigen), SCC (Squamous Cell Carcinoma Antigen), TPS (Tissue Polypeptide Specific Antigen) and CYFRA 21-1 in head and neck cancer patients, for assessing treatment response and prognosis of patients.
  
  
  METHODS
  We evaluated 312 blood samples from 143 head and neck cancer patients, from several sub-groups: 82 Larynx Carcinoma pre- and 38 post-therapy, 46 Oral Cavity pre and 29 post-therapy, 12 nasopharynx, 16 parotid and other salivary gland patients. Blood tumor markers levels were evaluated by conventional ELISA assays. Correlations of marker levels to stage of disease, lymph node involvement and therapy, were performed.
  
  
  RESULTS
  Serum levels of all four tumor markers were higher before therapy and decreased thereafter in all patients. The decrease in TPS level following therapy was significant (p=0.03). Significantly higher levels of TPS and similarly higher levels of the other tumor markers were demonstrated in advanced disease (stages III and IV) patients, as opposed to early disease (stages I and II) patients (p=0.012). Node positive patients had significantly higher TPS levels as compared to node negative (p=0.02). The same trend was shown by the other markers as well, but did not reach statistical significance. TPS was best correlated to survival of patients; those having low levels had the best clinical outcome and longer survival.
  
  
  CONCLUSIONS
  CEA, SCC, TPS and CYFRA 21-1 can all serve as useful tumor markers in HNC patients. They assessed response to therapy and were prognostic for recurrence. TPS proved to be the most sensitive predictor of advanced disease and poor prognosis.
authors.affiliation: Department of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel barakvivi@hadassah.org.il barakvivi@gmail.com.
authors.forename: Vivian
authors.initials: V
authors.lastname: Barak
authors.affiliation: Department of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Amichay
authors.initials: A
authors.lastname: Meirovitz
authors.affiliation: Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Vera
authors.initials: V
authors.lastname: Leibovici
authors.affiliation: Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Rachmut
authors.affiliation: Department of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Peretz
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Eliashar
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Menachem
authors.initials: M
authors.lastname: Gross
mesh_terms: D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D003131:Combined Modality Therapy; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D009367:Neoplasm Staging; D010455:Peptides / Q000097:blood*; D011379:Prognosis; D015843:Serpins / Q000097:blood*
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D010455:Peptides; D015843:Serpins; C102012:antigen CYFRA21.1; C051072:squamous cell carcinoma-related antigen; C089984:tissue polypeptide specific antigen
keywords: Head and neck cancer; clinical utility; tumor markers