Clinical significance of serum basic fetoprotein and various tumor markers in primary lung cancer

Background: To investigate the clinical significance of basic fetoprotein in lung cancer, serum basic fetoprotein was measured in 81 patients with primary lung cancer and 40 patients with other nonmalignant pulmonary diseases. Methods: For comparison, various tumor markers such as carcinoembryonic antigen, sialyl Lewis(x)-1 (SLX), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), tissue polypeptide antigen, squamous cell carcinoma related antigen (SCC), and neuron specific enolase were also measured. Results: Fifty-nine percent of the patients with primary lung cancer had a positive basic letoprotein level. This rate was higher than that for carcinoembryonic antigen and tissue polypeptide antigen, but lower than that for SLX. Histologic classification showed that basic letoprotein occurred more frequently in small cell and large cell carcinomas. Carcinoembryonic antigen and SLX showed high specificity in adenocarcinoma, and SCC and neuron specific enolase showed high specificity in squamous cell and small cell carcinoma, respectively. Basic letoprotein levels tended to be higher in the advanced stages of disease, and the change of basic fetoprotein levels was related to chemotherapeutic response. However, this tendency was not observed in patients who did not respond to chemotherapy; this was particularly pronounced in those with small cell carcinoma. In the study of various tumor markers, a correlation was observed only between basic fetoprotein and neuron specific enolase, which suggests that these 2 tumor markers are valuable in a combination assay. Conclusion: The measurement of basic fetoprotein is a useful method for monitoring the effectiveness of treatment in primary lung cancer.