Akciğer Kanserinin Tümör Belirteçleri ile Değerlendirilmesi: CEA, CA 19-9 ve CA 125

Yıl 2021, Cilt: 11 Sayı: 3, 282 - 287, 24.05.2021

Suphi Aydın , Aydın Balcı , Muhammed Emin

https://doi.org/10.16899/jcm.840949

Öz

Amaç: Akciğer kanseri (LC) yaygın ve ölümcül bir malignitedir. Tümör biyobelirteçleri, kanser hücreleriyle ilişkili ölçülebilir biyokimyasallardır. Tümör belirteçleri kanseri teşhis edemez; bunun yerine tanıyı desteklemek için laboratuar testleri olarak kullanılabilirler. Bu çalışmada tümör belirteçlerinin akciğer kanseri histolojik tiplerindeki yerini araştırmayı amaçladık.
Gereç ve Yöntem: Çalışmaya hastanemiz göğüs hastalıkları ve göğüs cerrahisi bölümlerine başvuran% 79'u erkek 33-84 yaş aralığında 121 evre IV akciğer kanseri hastası alındı. CEA, CA 19-9, CA 125, immünoassay tekniği ile çalışıldı. Sağkalıma etkileri araştırıldı. LDH, enzimatik yöntemle tümör yükü ve dönüşüm tespiti için analiz edildi. Hastalar, klinik parametreleri ayrıntılı olarak değerlendirmek için metastaz sayıları ve tanı sonrası yaşam süresine göre gruplara ayrıldı.
Sonuç: Adenokarsinom tipinde CEA, küçük hücre alt tipinde CA 19-9, skuamöz tipte CA 125 diğer histolojik alt tiplere göre anlamlı derecede yüksekti (p = 0.037, p = 0.031, p = 0.021). İkiden fazla metastazı olan hastalarda CEA, CA 19-9, CA 125 değerleri anlamlı olarak arttı (p = 0,047, p = 0,039, p = 0,028). Tümör <3cm, 3-5cm,> 5cm olarak üç gruba ayrıldığında, CA 19-9 ve CEA düzeyleri tümör çapı ile orantılı olarak artarken, CA 12-5 düzeyleri istatistiksel bir ilişki göstermedi.
Sonuç: Adenokarsinom tipi için CEA ve CA 19-9, küçük hücreli akciğer kanseri için CA 19-9 ve skuamöz hücre tipi için CA 125, hastaların prognozunu tahmin etmeye yardımcı olabilir.

Anahtar Kelimeler

kanser, biyobelirteç, tümör, metastaz

Evaluating Lung Cancer with Tumor Markers: CEA, CA 19-9 and CA 125

Öz

Aim: Lung cancer (LC) is a common and mortal malignancy. Tumor biomarkers are measurable biochemicals associated with cancer cells. Tumor markers cannot diagnose cancer; instead, they can be used as laboratory tests to support the diagnosis. In this study, we aimed to investigate the place of tumor markers in lung cancer histological types.
Materials and Methods: The study included 121 stage IV lung cancer patients, 79% of whom were male, between the ages of 33-84, who were admitted to the chest diseases and thoracic surgery departments of our hospital. CEA, CA 19-9, CA 125 were studied with the immunoassay technique. Its effects on survival were investigated. LDH was analyzed for determination of tumor burden and transformation by enzymatic method.
Patients were divided into groups according to the number of metastases and survival after diagnosis to evaluate clinical parameters in detail.
Result: CEA in the adenocarcinoma type, CA 19-9 in the small cell subtype, CA 125 in the squamous type were significantly higher than the other histological subtypes (p = 0.037, p = 0.031, p = 0.021). CEA, CA 19-9, CA 125 values were significantly increased in patients with more than two metastases (p=0.047, p=0.039, p=0.028). When the tumor was divided into three groups as <3cm, 3-5cm, >5cm, CA 19-9 and CEA levels increased in proportion to tumor diameter, while CA 12-5 levels did not show a statistical relationship.
Conclusion: CEA and CA 19-9 for adenocarcinoma type, CA 19-9 for small cell lung cancer and CA 125 for squamous cell type can help predict patients' prognosis.

Anahtar Kelimeler

cancer, biomarker, tumor, metastasis

Kaynakça

• 1. Smith RA, Cokkinides V, Eyre HJ. Cancer screening in the United States, 2007: a review of current guidelines, practices, and prospects. CA Cancer J Clin 2007;57:90–104
• 2. MacMahon H, Engelmann R, Behlen FM, Hoffmann KR, Ishida T, Roe C, et al. Computer-aided diagnosis of pulmonary nodules: results of a large-scale observer test. Radiology. 1999;213:723–726
• 3. Bhatt AN, Mathur R, Farooque A, Verma A, Dwarakanath BS. Cancer biomarkers – Current perspectives. Indian J Med Res. 2010;132:129–49
• 4. Sung HJ, Cho JY. Biomarkers for lung cancer diagnosis and their advances in proteomics. BMB Rep. 2008;41:615–625. DOI: 10.5483/BMBRep.2008.41.9.615
• 5. Gan N, Jia L, Zheng L (2011-10-28). "A sandwich electrochemical immunosensor using magnetic DNA nanoprobes for a carcinoembryonic antigen." International Journal of Molecular Sciences. 12 (11): 7410–23
• 6. Serum tumor markers. Perkins GL, Slater ED, Sanders GK, Prichard JG. http://www.aafp.org/afp/2003/0915/p1075.html. Am Fam Physician. 2003;15:1075–1082
• 7. Yin BW, Lloyd KO (Jul 2001). "Molecular cloning of the CA125 ovarian cancer antigen: identification as a new mucin, MUC16". The Journal of Biological Chemistry. 276 (29): 27371–5
• 8. Yin BW, Dnistrian A, Lloyd KO (Apr 2002). "Ovarian cancer antigen CA125 is encoded by the MUC16 mucin gene". International Journal of Cancer. 98 (5): 737–40
• 9. Bast RC, Xu FJ, Yu YH, Barnhill S, Zhang Z, Mills GB (1998). "CA 125: the past and the future". The International Journal of Biological Markers. 13 (4): 179–87
• 10. Duffy MJ, Duggan C, Keane R, et al. (March 2004). "High preoperative CA 15-3 concentrations predict adverse outcome in node-negative and node-positive breast cancer: a study of 600 patients with histologically confirmed breast cancer". Clin. Chem. 50 (3): 559–63
• 11. CA15-3 and alkaline phosphatase as predictors for breast cancer recurrence: a combined analysis of seven International Breast Cancer Study Group trials - Keshaviah et al. 18 (4): 701 - Annals of Oncology. 2007
• 12. Perkins, G.; Slater, E.; Sanders, G.; Prichard, J. (2003). "Serum tumor markers." American Family Physician. 68 (6): 1075–1082
• 13. Masaki Tomita M, Ayabe T, Nakamura ECK. Correlation between Serum Carcinoembryonic Antigen Level and Histologic Subtype in Resected Lung Adenocarcinoma. Asian Pacific Journal of Cancer Prevention, Vol 16, 2015. DOI:http://dx.doi.org/10.7314/APJCP.2015.16.9.3857
• 14. Nasralla A, Lee J, Dang J, Turner S. Elevated preoperative CEA is associated with subclinical nodal involvement and worse survival in stage I non-small-cell lung cancer: a systematic review and meta-analysis. J Cardiothorac Surg. 2020;15(1):318. Published 2020 Oct 15. doi:10.1186/s13019-020-01353-2
• 15. Prieto De Paula JM, Mayor Toranzo E, Gallardo Borge L, Franco Hidalgo S. Small-cell lung cancer and elevated CA 19.9 tumor marker levels. Arch Bronconeumol. 2012;48(10):385-386. doi:10.1016/j.arbres.2012.03.004
• 16. Molina R, Filella X, Augé J, M, Fuentes R, Bover I, Rifa J, Moreno V, Canals E, Viñolas N, Marquez A, Barreiro E, Borras J, Viladiu P: Tumor Markers (CEA, CA 125, CYFRA 21-1, SCC and NSE) in Patients with Non-Small Cell Lung Cancer as an Aid in Histological Diagnosis and Prognosis. Tumor Biol 2003;24:209-218. doi: 10.1159/000074432
• 17. Rottenberg Y, Nisman B, Peretz T. Extreme high levels of CA19-9 associated with adenocarcinoma of the lung. Isr Med Assoc J. 2009;11(2):116-117
• 18. Molina R, Auge J, M, Escudero J, M, Marrades R, Viñolas N, Carcereny E, Ramirez J, Filella X: 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. Tumor Biol 2008;29:371-380. doi: 10.1159/000181180
• 19. Trapé J, Buxo J, Pérez de Olaguer J, Vidal C. Tumor markers as prognostic factors in treated non-small cell lung cancer. Anticancer Res. 2003;23(5b):4277-4281
• 20. Giovanella L, Piantanida R, Ceriani L, et al. 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. The International Journal of Biological Markers. 1997;12(1):22-26. doi:10.1177/172460089701200105
• 21. Susana Cedrés, Isaac Nuñez, Marina Longo, Pablo Martinez, Eva Checa, Davis Torrejón, Enriqueta Felip, Serum Tumor Markers CEA, CYFRA21-1, and CA-125 Are Associated With Worse Prognosis In Advanced Non–Small-Cell Lung Cancer (NSCLC), Clinical Lung Cancer, Volume 12, Issue 3, 2011, Pages 172-179, ISSN 1525-7304, https://doi.org/10.1016/j.cllc.2011.03.019
• 22. Susana Cedrés, Isaac Nuñez, Marina Longo, Pablo Martinez, Eva Checa, Davis Torrejón, Enriqueta Felip, Serum Tumor Markers CEA, CYFRA21-1, and CA-125 Are Associated With Worse Prognosis In Advanced Non–Small-Cell Lung Cancer (NSCLC), Clinical Lung Cancer, Volume 12, Issue 3, 2011, Pages 172-179, ISSN 1525-7304, https://doi.org/10.1016/j.cllc.2011.03.019
• 23. Díez, M., Torres, A., Maestro, M. et al. Prediction of survival and recurrence by serum and cytosolic levels of CEA, CA125, and SCC antigens in resectable non-small-cell lung cancer. Br J Cancer 73, 1248–1254 (1996). https://doi.org/10.1038/bjc.1996.239
• 24. Pecchio F, Rapellino M, Oliaro A et al. Luborarorio Baldi e Riberi, Ospedale S. Giovanni. Torino. Minerva Med 1988;79: 183-6
• 25. Hatzakis K, D, Froudarakis M, E, Bouros D, Tzanakis N, Karkavitsas N, Siafakas N, M: Prognostic Value of Serum Tumor Markers in Patients with Lung Cancer. Respiration 2002;69:25-29. doi: 10.1159/000049366