Prognostic value of CYFRA 21-1, TPS and CEA in different histologic types of non-small cell lung cancer

The prognostic value of the tumor markers CYFRA 21-1, tissue polypeptide sp ecific antigen (TPS) and carcinoembryonic antigen (CEA) was investigated in three histologic subtypes of non-small cell lung cancer. Pretreatment sara n marker levels were measured in 38 patients with adenocarcinoma (AC), in 4 3 patients with squamous cell carcinoma (SQC) and in 35 patients with large cell carcinoma (LCC). Univariate analysis in AC showed significant lower s urvival of patients with elevated levels of TPS, CYFRA 21-1 and CEA. In LCC , elevated levels of TPS and CEA were found to predict lower survival, whil e in SQC - only TPS was a predictor: A multivariate analysis of survival id entified CEA (Relative Risk-5.5; p=0.004), CYFRA 21-1 (RR-3.4; p=0.008) and TPS (RR-3.0; p=0.02) as independent prognostic factors in AC. In sect only TPS (RR-2.3; p=0.03) was such a factor whereas in LC - none of the markers studied retained statistical significance. Thereafter; the combinations of the two strongest prognostic factors in the AC group - CEA and CYFRA 21-1 were explored to divide this group into subsets with different prognosis. I n cases where both markers were positive, the relative risk of death was 10 .5 times higher as compared to cases where both markers were negative (p=0. 002).