Phosphohexose isomerase (PHI) and carcinoembryonic antigen (CEA) were measured at the time of diagnosis in 300 patients with lung cancer. Serum levels were high in 75.7% and 53.0% of patients respectively. PHI levels were higher in large cell and small cell carcinomas (p < 0.001). CEA levels were higher in adenocarcinomas (p < 0.001). Metastatic carcinomas showed higher levels on PHI and CEA than localized cases. Survival was significantly longer in patients with normal PHI (p < 0.001) and normal CEA (p < 0.005) than in cases with elevated markers. The prognostic significance of PHI persisted in the different pathological types and stages, whereas CEA only had prognostic impact in non-small cell cases. Serial PHI determinations were useful for follow-up in 82.4% of cases with initial abnormal values and in 55.4% of cases with a normal value. Serial CEA was useful in 41% of cases with initially high value but in less than 15% of those with baseline normal. We conclude that PHI has prognostic significance independently of pathology and stage, whereas CEA was a prognostic indicator only in non-small cell cases; serial PHI determinations were useful more often than CEA for follow-up.
TormeyD.C., DavisT.E., WaalkesT.P.Tumor markers, in CarterS.K., GlatsteinE., LivingstonR.B. (eds). Principles of Cancer Treatment, New York, Mc Graw-Hill, 1982; 170–7.
2.
SugarbakerP.H., ReedN., SugarbakerE.V.Tumor markers, in De VitaV.T.Jr., HellmanS., RosenbergS.A. (eds). Cancer: Principles & Practice of Oncology.Philadelphia, JB Lippincott, 1982; 248–54.
3.
WaldmanT.A., HerbermanR.B.Tumor markers in diagnosis and in monitoring therapy, in HollandJ.F., FreiE.III (eds). Cancer Medicine.Philadelphia, Lea & Febiger, 1982; 1068–89.
4.
Van NagellJ.R., DonalsonE.S., HansonM.B.. Biochemical markers in the plasma and tumors of patients with gynecologic malignancies.Cancer1981; 48: 495–503.
5.
RosenS.W., WeintraubB.D., VaitukaitisJ.L.. Placental proteins and their subunits as tumor markers.Ann Intern Med1975; 82: 7178.
6.
JavadpourM., McIntireR., WaldmanT.A.. The role of radioimmunoassay of serum alphafetoprotein and human chorionic gonadotropin in the intensive chemotherapy and surgery of metastatic testicular tumors.J Urol1978; 119: 759–62.
7.
SilverbergE.Cancer statistics, 1980; CA 30: 2338.
8.
RosenS.W., BeckerC.E., SchlaffS.Ectopic production before clinical recognition of bronchogenic carcinoma.N Engl J Med1968; 276: 640–5.
9.
SappinoA.P., EllisonM.L., CarterS.C., SmithI.E.Correlation of three tumor markers (calcitonin, CEA and beta-hCG) with response to therapy and extent of disease in small cell lung cancer.Br J Cancer1981; 44: 300–7.
10.
MuggiaF.M., RosenS.W., WeintraubB.D., HansenH.H.Ectopic placental proteins in nontrophoblastic tumors. Serial measurements following chemotherapy.Cancer1975; 36: 1327–33.
11.
Mc IntireK.R.Nonhormone markers of human lung cancer.International Symposium on Markers for Diagnosis and Monitoring of Human Cancer,Milan, 1981; 45.
12.
BellC.E.Jr., A normal adult and fetal lung antigen present at different quantitative levels in different histologic types of human lung cancer.Cancer1976; 37: 706–13.
13.
BraatzJ.A., McIntireK.R., PrinclerG.L.. Purification and characterization of a human lung tumor-associated antigen.J Ntl Cancer Inst1978; 61: 1035–46.
14.
WolfA., MickscheM., MauerH.An improved antigenic marker of human lung carcinomas and its use in radioimmunoassay.Br J Cancer1981; 43: 267–75.
15.
PrinclerG.L., McIntireR., BraatzJ.A.Identification and purification of a human tumor-associated antigen from a primary lung tumor.Cancer Res1982; 42: 843–8.
16.
GoldP., FreedmanS.O.Demonstration of tumor specific antigens in human colonic carcinoma by immunological tolerance and absorption techniques.J Exp Med1965; 121: 439–62.
17.
ConcannonJ.P., DalbowM.H., LieblerG.A.. The CEA assay in bronchogenic carcinoma.Cancer1974; 34: 184–92.
18.
GautierH., HugueninP., LededenteA.. Etude du dosage de l'ACE dans les cancers bronchiques non traités.Bull Cancer1976; 63: 699–704.
19.
FordC.H.J., NewmanC.E., LakinJ.Rôle of carcinoembryonic antigen in bronchial carcinoma.Thorax1977; 32: 582–8.
20.
DentP.B., McCullochP.B., Wesley-JamesO.. Measurement of carcinoembryonic antigen in patients with bronchogenic carcinoma.Cancer1978; 42: 1484–91.
21.
BodanskyO.Serum phosphohexose isomerase in cancer: I. Method of determination and establishment of range of normal values.Cancer1954; 7: 1191–9.
22.
BodanskyO.Serum phosphohexose isomerase in cancer: II. As an index of tumor growth in metastatic carcinoma of the breast.Cancer1954; 7: 1200–26.
23.
BodanskyO.Serum phosphohexose isomerase in cancer: IV. Comparison with serum phosphoglucomutase activity in metastatic cancer.Cancer1957; 10: 865–76.
24.
WestM., SchwartzM.A., WalshW.S., ZimmermannH.J.Serum enzymes in disease: XI. Glycolytic and oxidative enzymes and transaminases in patients with cancer of the lung.Cancer1962; 15: 931–43.
25.
BalcellsA., Pérez-SandovalD., Del ArcoJ.A.Fosfohe-xosa isomerasa, deshidrogenasa isocitrica y fosfatasa alcalina en enfermos neoplásicos.Rev Clin Esp1967; 106: 357–63.
26.
BrunoG.F., FaillaG., FotiE., MarcheseV.Significato clinico del dosaggio della fosfoesosoisomerasi serica nelle neoplasie maligne.Min Med1978; 69: 749–56.
27.
TNM Classification of Malignant Tumours.Third Edition.UICC, Geneva, 1978.
28.
ZelenM.Keynote address on biostatistics.Cancer Chemother Rep1973; 4: 31–42.
29.
EstapéJ., MilláA., AgustiA.. VP 16213 (VP 16) and cyclofosfamide in the treatment of primitive lung cancer in phase M.Cancer1979; 43: 72–9.
30.
EstapéJ., MilláA., AgustiA.. VP-16 plus cyclophosphamide in the treatment of advanced lung cancer.Cancer1983; 51: 385–9.
31.
BuedingE., MackinnonJ.A.Studies of the phosphohexose isomerase of schistosoma mansoni.J Biol Chem1955; 215: 507–13.
32.
MolinaR., BallestaA.M., ElenaM.. Antigeno carcinoembrionario y fosfohexosa isomerasa en cáncer de mama.Rev Diag Biol1982; 21: 209–16.
33.
KaplanG.L., MeierP.Nonparametric estimations from incomplete observations.Am Statist Ass J1958; 53: 457–81.
34.
PetoR., PikeM.C.Conservation of the approximation (O-E)2/E in the log-rank test for survival data or tumor incidence data.Biometrics1973; 29: 579–84.
35.
ShinkaiT., SaijoN., TominagaK.. Serial plasma carcinoembryonic antigen measurement for monitoring patients with advanced lung cancer during chemotherapy.Cancer1986; 57: 1318–23.
36.
AroneyR.S., ErmodyW.C., AldenferferP.. Multiple sequential biomarkers in monitoring patients with carcinoma of the lung.Cancer Treat Rep1984; 68: 859–66.
37.
FarinaM.P., ZanettiP.P., MazzeoG.. Utilità della valutazione di livelli sierici della fosfoesosoisomerasi (PHI) nella diagnosi delle forme neoplastiche.Arch Sc Med1980; 137: 485–7.
38.
SantabárbaraP., MolinaR., BallestaA.M.. Preliminary results of phosphohexose isomerase and carcinoembryonic antigen in lung cancer. In PeetersH. (ed): Protides of the Biological Fluids XXXI.Oxford, Per-gamon Press, 1984.
39.
Di MartinoG., Di MatteoL., De BellisG.. I livelli sierici di GPI, Al AT e CEA nelle neoplasie polmonari primitive e nelle broncopneumopatie croniche.Boll 1st Sieroter Milan1979; 58: 344–55.
40.
VincentR.G., ChuT.M., FergenT.B., OstranderM.Carcinoembryonic antigen in 228 patients with carcinoma of the lung.Cancer1979; 36: 2069–76.
41.
WaalkesT.P., AbeloffM.D., WooK.B.. Carcinoembryonic antigen for monitoring patients with small cell carcinoma of the lung during treatment.Cancer Res1980; 40: 4420–7.
42.
LokichJ.J.Plasma CEA levels in small cell lung cancer: Correlation with stage, distribution of metastases, and survival.Cancer1982; 50: 2154–6.
43.
ViettiD., BonardiL., FerraresiG., FerreroL.La determinazione della fosfoesosoisomerasi (PHI) quale ausilio diagnostico nello screening e nella prognosi delle neoplasie maligne.Min Med1981; 72: 1087–9.
44.
ConcannonJ.P., DalbowM.H., HodgsonS.E.. Prognostic value of preoperative carcinoembryonic antigen (CEA) plasma levels in patients with bronchogenic carcinoma.Cancer1978; 42: 1477–83.
45.
KairaJ., SteinJ., MarchionyA., ChuT.M.Prognostic value of plasma CEA in the survival of squamous cell carcinoma of the lung.Proceedings AACR-ASCO1979; 20: 1049.
46.
MalkinA., MalkinD.G., EvansW.K., FeldR.Prognostic value of plasma carcinoembryonic (CEA) determinations in small cell lung cancer.Proceedings AACR-ASCO1981; 22: 736.
47.
SculierJ.P., FeldR., EvansF.A.. Carcinoembryonic antigen: a useful prognostic marker in small-cell lung cancer.J Clin Oncol1985; 3: 1349–54.
48.
LokichJ.J., EllenbergS., GersonB.Criteria for monitoring carcinoembryonic antigen. Variability of sequential assays at elevated levels.J Clin Oncol1984; 2: 181–6.
