TUMOR-MARKERS IN THE DIAGNOSIS AND FOLLOW-UP OF HEAD AND NECK-CANCER - ROLE OF CEA, CA-19-9, SCC, TK, AND DTTPASE

The clinical relevance of the carcinoembryonic antigen (CEA), carbohyd rate antigen (CA) 19-9, squamous cell carcinoma antigen (SCC), thymidi ne kinase (TK), and deoxythymidine-5'-triphosphatase (dTTPase) as tumo r markers in the diagnosis and follow-up treatment of 26 patients with head and neck cancer is evaluated. Serum levels prior to treatment we re found elevated just above the upper limit of normal in 46% (SCC), 1 5% (CEA), 12% (CA 19-9), 27% (TK), and 39% (dTTPase) of all patients. If all markers were taken into account, they were elevated in 73% of t he untreated patients. However, only in a few cases were the tumor mar ker values elevated significantly (8%-12%). No significant correlation was detected between serum levels and tumor localization, staging, gr ading, or performance status for any of the markers. In the follow-up none of the markers tested revealed any disease-related information de spite therapy variation. Patients with originally elevated marker leve ls showed decreasing and in some cases increasing values after primary therapy, although no tumor recurrence was detected. Even considering the results as preliminary due to the rather small sample size, they s uggest that the routine assessment of CEA, CA 19-9, SCC, TK, and dTTPa se serum levels is of limited practical value.