MUCIN-1 ANTIGENS IN THE SERUM AND BRONCHIAL LAVAGE FLUID OF PATIENTS WITH LUNG-CANCER

Background. Lung cancer (LC) is the most common fatal malignancy, but there are no useful tumor markers for diagnosis or monitoring. Mucin 1 has an established role as a marker in other malignancies, but has un dergone limited assessment in LC. Methods. Serum from 86 patients with LC and 24 with benign pulmonary disease (BPD), and bronchial lavage f luid from 55 LC patients and 21 BPD patients were tested using the Muc in 1 assays mammary serum antigen (MSA) and cancer-associated serum an tigen (CASA). Results. For LC, serum CASA achieved sensitivity of 57%, specificity of 93% relative to normals, and 63% specificity relative to BPD. For MSA the same parameters were 19%, 95%, and 92%. Serum CASA levels were significantly higher in LC patients compared with BPD (P = 0.024) but there was no difference for MSA (P = 0.635). CASA showed excellent correlation with tumor stage and in patients with changing s tatus of disease, while MSA did not. By contrast there was no differen ce in bronchial lavage fluid tumor marker levels from LC and BPD patie nts (CASA, P = 0.87; MSA, P = 0.89). Conclusions. In a small series se rum CASA appears to be a useful agent in detecting LC because it is el evated in all types and stages of LC, and its level correlates with st age and progress of disease. Some patients with BPD have elevated leve ls suggesting a greater value for monitoring rather than diagnosis. Bo th serum MSA testing and measurements of either marker in bronchial la vage fluid are of no value.