Published in Cancer Detection and Prevention 1999; 23(4):309-315.

Neuron-Specific Enolase, Thymidine Kinase, and Tissue Polypeptide-Specific Antigen in Diagnosis and Response to Chemotherapy of Small-Cell Lung Cancer

Vincenzo Abbasciano, M.D.,a Sergio Sartori, M.D.,b Lucio Trevisani M.D.b Ingrid Nielsen, M.D.b Eros Ferrazzi, M.D.,e Antonio Bononi, M.D.e Silvia Toso, M.D.,e Giorgio Crepaldi, M.D., Maria Pia Bianchi,c Giuseppe Gillid Giorgio Zavagli M.D.a

a Istituto di Medicina Interna II, Università di Ferrara and b Dipartimento di Medicina ed Oncologia Medica, c Servizio di Medicina Nucleare, and d Servizio di Fisica Sanitaria, Azienda Ospedaliera S. Anna, Ferrara, Italy, and e Oncologia Medica, Ospedale di Rovigo, Rovigo, Italy

Address all correspondence and reprint requests to: Vincenzo Abbasciano, M.D., Istituto di Medicina Interna II, Università di Ferrara, Corso Giovecca 204, 1-44100 Ferrara, Italy.

ABSTRACT: The clinical usefulness of neuron-specific enolase (NSE), thymidine kinase (TK), and tissue polypeptide-specific antigen (TPS) was investigated in 41 patients (53-80 years old) with recently discovered small-cell lung cancer (SCLC). Eleven patients exhibited limited disease (LD) and 30 extensive disease (ED). Serum samples for NSE, TPS (immunoradiometric assay), and TK (radioenzymatic assay) evaluations were drawn from all patients at the time of diagnosis and before each cycle of chemotherapy in the treated patients. Therapy consisted of i.v. carboplatin 300 mg/m2 on the first day and i.v. etoposide 120 mg/m2 from the first to the third day every 3 weeks. Nine patients refused or were not eligible for chemotherapy. Five patients received only one course and showed no response (NR); 9 patients received two courses; 18 patients received three or more courses. In the last group, complete remission (CR) was obtained in 9 cases, partial remission (PR) in 18 cases. The tumor markers studied did not show any significant difference in distinguishing LD from ED. NSE and TPS were significantly more often abnormal than TK, either at the time of diagnosis (p <0.05) or in PR or NR patients (p <0.05). In relation to chemotherapy response, NSE and TPS serum patterns were shown to be more reliable than TK in PR (p <0.05) and NR patients (computed error between 10% and 15%). No significant difference was observed between serum NSE and TPS patterns. Serum NSE and TPS seem to be more useful in the diagnosis and follow-up of SCLC patients undergoing chemotherapy. Further trials are necessary to ascertain whether the associated assessment of NSE and TPS can add useful information to that provided by the assessment of NSE alone.

KEY WORDS: neuron-specific enolase, small-cell lung cancer, thymidine kinase, tissue polypeptide-specific antigen, tumor markers.