CA125 AND NEURON-SPECIFIC ENOLASE (NSE) AS TUMOR-MARKERS FOR INTRAABDOMINAL DESMOPLASTIC SMALL ROUND-CELL TUMORS

Seven consecutive patients with intra-abdomina[ desmoplastic smalt rou nd-cell tumours were screened at presentation for carcinoembryonic ant igen (CEA), Ca19-9, Ca15-3, Ca125, alpha-fetoprotein (AFP), human chor ionic gonadotrophin (hCG) and neuron-specific enolase (NSE). lnitially elevated tumour markers were used to monitor therapy and follow-up, T umour marker assays were all in the normal range, with the exception o f Ca125 and NSE. The Ca125 level was initially high in six of the seve n patients (86%) with a median value or 200 U ml(-1) and a range of 22 -735 U ml(-1). The NSE value was elevated before therapy in three of t he five patients (60%) for whom assay results were available, with a m edian of 19 ng ml(-1) and a range of 6.8-37.5 ng ml(-1). Ca125 normali zed in five out of six cases and NSE always normalized during chemothe rapy, but neither of these two tumour markers correlated specifically with response, as only one patient experienced a partial response, fiv e tumour stabilization and the remaining patient tumour progression. A t progression, Ca125 was again elevated in two out of four cases sever al weeks before clinical relapse and NSE in only one out of three case s. Ca125 and NSE are frequently raised in the serum of patients with i ntra-abdominal desmoplastic smalt round-cell tumours before therapy, b ut are not reliable monitors of the course of the disease. However, no rmalization is frequently associated with an improvement of symptoms o r a moderate clinical response.