UMLS:C0149925 - FACTA Search

Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Target Concepts:

Query: UMLS:C0149925 (small cell lung cancer)
6,491 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

NSE is a biochemical marker for small cell lung cancer (SCLC) diagnosis and management. CYFRA 21.1 is a newly developed immunoassay to detect the serum fragments of cytokeratin 19 which are also expressed in SCLC with or without neurofilaments. The aim of this study was to evaluate the diagnostic performance and prognostic role of the two markers in SCLC and their contribution to chemotherapy monitoring and patient follow-up. We studied 62 patients with pathologically proven SCLC: 28 with limited disease (LD) and 34 with extensive disease (ED), and 100 patients with non-malignant pulmonary disease. Immunoradiometric assays (IRMA) were employed to test NSE and CYFRA 21.1 in patients and control subjects. For each patient subset results were expressed as median and interquartile distribution range. NSE and CYFRA 21.1 sensitivity was 0.52 (33/62) and 0.56 (35/62), respectively. In the group of patients with LD, NSE and CYFRA 21.1 sensitivity was 0.42 (12/28) and 0.54 (15/28) and in patients with ED, NSE and CYFRA 21.1 were positive in 0.62 (21/34) and 0.59 (20/34) of cases, respectively. Combining the two markers, a sensitivity of 0.78 (22/28) in LD, 0.82 (28/34) in ED and a global sensitivity of 0.80 (50/62) was obtained. Only NSE was significantly linked to the extension of disease (Mann-Whitney U test p = 0.002) while CYFRA 21.1 did not correlate. The analysis of survival and the evaluation of the two markers at diagnosis showed CYFRA 21.1 to be strongly linked to the patients' outcome, independently of both clinical prognostic factors and NSE levels (log rank and Cox's model). The markers' performance during chemotherapy was tested in a group of 33 patients with at least one marker above cut-off. NSE can be considered a reliable marker of tumor mass modifications under chemotherapy, while CYFRA 21.1 expression seems to be relatively independent of tumor volume modifications. An applicable model of biomarkers in SCLC could be the concurrent assay of NSE and CYFRA 21.1 in pre-therapeutic assessment and therapy planning. CYFRA 21.1 does not play an important role during therapy monitoring and follow-up; in these phases NSE alone may be employed.
...
PMID:Immunoassay of neuron-specific enolase (NSE) and serum fragments of cytokeratin 19 (CYFRA 21.1) as tumor markers in small cell lung cancer: clinical evaluation and biological hypothesis. 917 14

In a series of 381 consecutive patients with lung tumors and benign pulmonary diseases, we examined whether tumor markers CYFRA 21-1 (EIA, Boehringer, Mannheim), TPA-M (IRMA AB Sangtec Medical, Bromma, Sweden), TPS (IRMA, Beki Diagnostics AB, Bromma, Sweden), CEA and NSE (EIA, Roche, Basel) have the potential to contribute to clinical decision-making processes with respect to diagnosis and assessment of response to therapy. The sensitivity values of the marker tests in NSCLC (CYFRA 21-1: 44.4% > 3.9 ng/ml, TPA-M: 39.4% > 200 U/ml, TPS: 13.2% > 230 U/ml, CEA: 37.5% > 8.6 ng/ml), in SCLC (NSE: 61.9% > 14.0 ng/ml) and in pleural mesothelioma (CYFRA 21-1 and TPS: 36.4%) were found to be clearly inferior to the yield of standard cytopathological examinations (85-98%) when using the 95% specificity versus the group with benign pulmonary disease as cut-off values. Therefore, currently available tumor markers are of minor value in the primary diagnosis of lung tumors. After curative surgery (Ro) of NSCLC only CYFRA 21-1 levels dropped to the normal range within one week. The other markers simulated residual tumor mass by displaying elevated marker levels after surgery. During the monitoring of response to chemo-/radiotherapy the changes in marker levels were compared to the clinical assessment according to standard criteria of the WHO. The criteria defined for marker response were a 65% decrease for a partial response and a 40% increase of the marker levels for progressive disease. Concordant results were obtained in 59.4% of the cases for CYFRA 21-1 (TPA-M: 63.3%, TPS: 65.5%, CEA: 54.8%, NSE: 68.9%). Most discordant results were obtained in tumor remission due to an insufficient decrease in the markers. Progressive disease was most effectively indicated by CYFRA 21-1 in NSCLC 60%) and by NSE in SCLC (70.0%). It is concluded that increasing marker levels may contribute to clinical decision making, at least in helping to decide which patients should no longer treated by ineffective and toxic drugs.
...
PMID:Monitoring of therapy in inoperable lung cancer patients by measurement of CYFRA 21-1, TPA- TP CEA, and NSE. 932 52

It is believed that the tissue or serum expression of neuroendocrine markers in non small cell lung cancer patients can implicate better prognosis in cases undergoing chemotherapy. The aim of the study was to assess the value of NSE serum level for anticipation of the tumor response to chemotherapy. We found elevated serum level of NSE in 34 of 60 patients (56.7%) at the time of diagnosis of inoperable non small cell lung cancer, significantly more often in those presenting stage IV of disease. In 21.7% partial response and in another 21.7% minimal regression was found after chemotherapy. Treatment results revealed no significant differences in respect to NSE serum level, however 77% of patients achieving partial response had elevated serum level of NSE.
...
PMID:Neuron-specific enolase (NSE) serum level in non small cell lung cancer--can it be an indicator of tumour chemosensitivity? 933 35

CEA, NSE and SCC Ag levels were measured in bronchial lavage (BL) and serum in patients with endobronchial lung cancer (LC) and in patients with nonmalignant lung diseases (NMLD). In both groups of patients 100 ml of normal saline solution was used during the lavage procedure. Tumor markers were detected using radioimmunoassay. CEA levels in BL and in serum were measured in 84 patients with LC and in 94 patients with NMLD. BL CEA levels were significantly increased in patients with LC (97.4 +/- 56.4 ng/ml) in comparison to patients with NMLD (4.2 +/- 6.3 ng/ml). Patients with LC had CEA levels in lavage fluid about 30 times higher than in serum. Significantly increased BL CEA levels in patients with LC were found in the cases with more advanced bronchoscopic tumor and in those with positive bronchial secretion cytology than in other groups of patients with LC. NSE levels were measured in BL and in serum in 21 patients with small cell lung cancer, SCC Ag levels were measured in BL and in serum in 21 patients with squamous cell carcinoma. The control group consisted of 28 patients with NMLD and 8 patients with adenocarcinoma. Determination of CEA levels in BL can be useful additional diagnostic method in patients with LC. The measurement of NSE and SCC Ag levels in BL in LC patients was considered to be not useful because of the low diagnostic sensitivity and specificity.
...
PMID:CEA, NSE and SCC Ag in bronchial lavage in patients with lung cancer. 933 36

Small cell lung cancer (SCLC) is considered as a disseminated disease in most cases. Staging is important to define whether the patient has limited disease and should stop after diagnosis of extensive disease, unless the patient is part of a staging or therapy protocol. Assessment of other prognostic factors, like performance status, tumour spread, age, sex, tumour response and laboratory results (LDH, AP, Albumin, Sodium, NSE, CEA) is important especially for stratification of randomised trials. Untreated the median survival is 6-8 weeks. At least initially SCLC is very sensitive to chemotherapy like cyclophosphamide, doxorubicin and vincristin (VAC) or cisplatin and etoposide (EP) and the median survival is increased to 10-14 months. Symptomatic relief is often dramatically with 70-80% of patients obtaining relief within one month of starting chemotherapy. Radiotherapy improves local tumour control. Surgery should be done if a R0-resection seems to be possible. The value of high dose chemotherapy with stem cell support is tested in current clinical trials.
...
PMID:[Prognostic factors and therapeutic strategies in small cell bronchial carcinoma]. 943 88

The aim of this study was (i) to determine predictive factors of a complete response to chemotherapy in small cell lung cancer (SCLC) and predictive factors of an objective response in non-small cell lung cancer (NSCLC) and (ii) to determine whether prognostic factors are different with regard to treatment response and survival. Ninety-nine patients with SCLC and two hundred and two patients with NSCLC received chemotherapy. The following variables were recorded prior to treatment: tumor, node, metastasis status, performance status, body weight loss, blood leukocyte count, serum sodium, serum albumin, lactate dehydrogenase (LDH), alkaline phosphatase, serum NSE, serum TPS, and serum CYFRA 21-1. Tumor response was analyzed at the 10th week. Analysis of survival were done using the landmark method. Hazard ratios of the significant prognostic variables of survival were calculated using the Cox's model. Odds ratios of the significant predicting factors of response were calculated by stepwise logistic regression. In SCLC, the significant determinants of poor survival were: lack of complete response (HR: 2.04), weight loss (HR: 1.76), high serum LDH level (HR: 1.64), and high serum TPS level (HR: 2.47). A high serum TPS level was the only factor among those studied able to predict lack of achievement of complete response (OR: 0.39). In NSCLC, significant determinants of poor survival were: no objective response (HR: 2.28), poor performance status (HR: 2.52), presence of metastases (HR: 1.51), and high serum CYFRA 21-1 level (HR: 1.84). On the other hand, a high serum TPS level (OR: 0.50), the presence of metastases (OR: 0.45), and a leukocyte blood count over 10,000/microl (OR: 0.43) were independent determinants for a patient not to achieve an objective response. We concluded that the predictive factors of complete response in SCLC remain to be defined. On the other hand, in NSCLC three variables contribute to the prediction of an objective response. Finally, determinants of survival differ from predictive factors of response.
...
PMID:Predictive factors of tumor response and prognostic factors of survival during lung cancer chemotherapy. 967 72

High serum NSE and advanced tumour stage are well-known negative prognostic determinants of small cell lung cancer (SCLC) when observed at presentation. However, such variables are reversible disease indicators as they can change during the course of therapy. The relationship between risk of death and marker level and disease state during treatment of SCLC chemotherapy is not known. A total of 52 patients with SCLC were followed during cisplatin-based chemotherapy (the median number of tumour status and marker level assessments was 4). The time-homogeneous Markov model was used in order to analyse separately the prognostic significance of change in the state of the serum marker level (NSE, CYFRA 21-1, TPS) or the change in tumour status. In this model, transition rate intensities were analysed according to three different states: alive with low marker level (state 0), alive with high marker level (state 1) and dead (absorbing state). The model analysing NSE levels showed that the mean time to move out of state 'high marker level' was short (123 days). There was a 44% probability of the opposite reversible state 'low marker level' being reached, which demonstrated the reversible property of the state 'high marker level'. The relative risk of death from this state 'high marker level' was about 2.24 times greater in comparison with that of state 0 'low marker level' (Wald's test; P < 0.01). For patients in state 'high marker level' at time of sampling, the probability of death increased dramatically, a transition explaining the rapid decrease in the probability of remaining stationary at this state. However, a non-nil probability to change from state 1 'high marker level' to the opposite transient level, state 0 'low marker level', was observed suggesting that, however infrequently, patients in state 1 'high marker level' might still return to state 0 'low marker level'. Almost similar conclusions can be drawn regarding the three-state model constructed using the tumour response status. For the two cytokeratin markers, the Markov model suggests the lack of a true reversible property of these variables as there was only a very weak probability of a patient returning to state 'low marker level' once having entered state 'high marker level'. In conclusion, The Markov model suggests that the observation of an increase in serum NSE level or a lack of response of the disease at any time during follow-up (according to the homogeneous assumption) was strongly associated with a worse prognosis but that the reversion to a low mortality risk state remains possible.
...
PMID:Markov model and markers of small cell lung cancer: assessing the influence of reversible serum NSE, CYFRA 21-1 and TPS levels on prognosis. 1018 85

Expression of a number of antigens associated with small cell lung cancer (SCLC) have been proposed as a marker of malignancy and the diagnostic tool for the staging procedures and important prognostic factor. Since the bone marrow (BM) was described as a frequent site for SCLC metastases, we have decided to assess clinical importance of cancer cells detection in BM, using immunofluorescence with MAC-1, MAC-31, NSE and anti-Fucosyl-GM1 (PF3) antibodies. The group of 32 patients with SCLC was assessed using our panel of antibodies. Control group consisted of 5 patients with other malignancies (3 patients with malignant lymphoma, 1 with chronic lymphocytic leukaemia and 1 with non-SCLC). The study revealed no correlation between the expression of SCLC markers in patients BM and the cancer treatment outcome measured as a response for treatment, time to progression, and survival time, and no significant difference was found between the patients and control group.
...
PMID:[The use of monoclonal antibodies in the detection of small cell lung cancer metastases in bone marrow]. 1048 25

A 68-year-old woman with recurrent advanced small cell lung cancer (SCLC), previously treated with 7 courses of carboplatin + etoposide, 4 courses of cisplatin + irinotecan and radiotherapy (primary site and whole brain irradiation), received 3 courses of a single nogitecan hydrochloride i.v. bolus with 4 consecutive days of administration, for a total dose of 7.5 mg. MR-imaging revealed a response in the brain metastasis, and tumor markers (NSE and ProGRP) were improved after the first course. Headache, her main complaint, was also alleviated. These observations suggest that nogitecan hydrochloride alone might be useful for treatment of recurrent SCLC in cases of poor performance status (PS), especially when the patient requires remission of symptoms.
...
PMID:[A case of recurrent small cell lung cancer with symptoms improved by nogitecan hydrochloride]. 1204 Jun 88

To evaluate the value of detection of 4 tumor markers(CEA, CA125, gastrin, and NSE) for histological types in patients with lung cancer and to improve the predicted efficiency of tumor markers for distinguishing between small cell lung cancer(SCLC) and non-small cell lung cancer (NSCLC), these 4 tumor markers in serum were determined in 51 patients (21 cases with SCLC, 30 cases with NSCLC) with confirmed primary diagnosis of lung cancer of different histology by radioimmunoassay. Linear learning machine method, PRIMA method and KNN method were used to classify SCLC and NSCLC. The levels of gastrin and NSE in SCLC were apparently higher than those of gastrin and NSE in NSCLC, but the levels of CEA and CA125 in SCLC were significantly lower than those in NSCLC. Smoking had an effect on the levels of CEA and CA125, but had little effect on those of gastrin and NSE. The total accuracy of the three methods was over 85% in distinguishing SCLC from NSCLC. So combined detection of the four tumor markers in serum might be useful in the prediction of histological types in patients with lung cancer.
...
PMID:[Value of combined detection of tumor markers for the prediction of small cell and non-small cell lung cancer]. 1252 Sep 21

<< Previous 1 2 3 4 5 6 7 Next >>