Evaluation of primary lung cancer with indium 111 anti-carcinoembryonic antigen (type ZCE-025) monoclonal antibody scintigraphy

Article Abstract:

Early intervention is regarded as very important for the reduction of illness and death due to lung cancer. Unfortunately, X-rays cannot distinguish between benign and malignant lesions. Although bronchoscopy can provide tissue biopsies which are definitive, it is useful only in those cases where the lesion is accessible. Another possibility is the use of specific antibodies for the evaluation of lung tumors. An antibody which recognizes an antigen specific for cancer cells may be labelled with a radioactive isotope and injected into the patient's circulation. If the antibody binds to the lesion, the increased radioactivity in that area may be detected by scintigraphy. Antibodies to carcinoembryonic antigen (CEA) are candidates for this technique; one particular antibody against CEA, designated ZCE-025, was labelled with the radioactive isotope indium 111 and evaluated in 20 patients scheduled to undergo surgery for lung tumors. After histological examination, nine tumors were found to be squamous cell carcinomas. Of these, eight were positive by scintigraphy after antibody administration. Four of the seven adenocarcinomas were positive by scintigraphy. Of the four tumors which were found to be benign after surgical removal, only one was positive by scintigraphy. The diagnosis based on the scintigraphic detection of radiolabeled antibody was 75 percent accurate for both positives (actual cancers) and negatives, or benign growths. Histological staining of 14 tumors using antibodies to CEA revealed that two tumors negative for CEA by direct staining were positive by scintigraphy, and three tumors positive for CEA by staining were negative by scintigraphy. The location of the tumor, its size, and the penetration of blood vessels into the tumor may all play a role in the detection of lung cancers using the antibody-scintigraphy method. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Monoclonal antibodies, Diagnostic imaging, Radionuclide imaging, Radioisotope scanning

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Evaluation of serum CA 125 as a tumor marker in non-small cell lung cancer

Article Abstract:

The notion of a serum tumor marker is intuitively appealing: that there could be a simple blood test for cancer screening at a routine physical. Unfortunately, the identification of an appropriate tumor marker has proved to be an elusive goal. One of the earliest and most promising potential tumor markers is a protein dubbed CA 125. Antibodies against this marker can identify the substance in the blood of some cancer patients. The test is reasonably specific; in some cases a positive result has over 90 percent chance of actually indicating the presence of cancer. Unfortunately, the sensitivity of this marker is not so good; the majority of the patients with cancer are negative for the antigen. Even worse, if the level of antigen is determined by the extent of cancer growth, it may be that screening for this tumor marker will result in the identification of only those cancer patients who are already too far gone to be helped. A study was undertaken to evaluate the potential usefulness of CA 125 in the diagnosis of lung cancer. Patients with small cell lung cancer were not included in this study. Serum CA 125 levels were measured in 130 healthy controls, 100 patients with non-small cell lung cancer, and 33 patients with benign lung lesions. Assigning a cutoff point of 15 units per milliliter, almost 100 percent of the positive subjects had lung cancer, but only 44 percent of the patients with lung cancer were positive. It was also observed that the patients with inoperable cancer were more likely to have elevated CA 125 levels than were patients whose disease was still amenable to surgical treatment. The authors suggest that the assay of serum CA 125 may be useful as an adjunctive test but is not sensitive enough to be a primary test for non-small cell lung cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Evaluation of squamous cell carcinoma antigen as a new marker for lung cancer

Article Abstract:

There is a great enthusiasm for the identification of tumor markers, specific antigens found on tumor cells and their corresponding antibodies. The detection of these markers in the blood often reveals malignancy. Translating this enthusiasm into clinically useful reagents has proven difficult, however. The carcinoembryonic antigen (CEA), among the first tumor markers discovered, remains one of the only with proven, albeit limited, usefulness. The more recently discovered squamous cell carcinoma antigen (SCC Ag) seems to show promise, however. This antigen, which was first identified in carcinoma of the uterine cervix, was evaluated along with CEA as a potential marker for lung cancer. Circulating levels of SCC Ag were measured in 382 healthy individuals, 129 patients with small cell lung cancer, and 162 with non-small cell lung cancer, of whom 96 had squamous cell carcinoma. The antigen was also measured in 90 patients with noncancerous lung disease. Elevated values of both SCC Ag and CEA were observed in 10 patients with benign pulmonary disease. The carcinoembryonic antigen was more sensitive in identifying cancer patients, even those with squamous cell carcinoma. The SCC Ag was more specific, however, for squamous cell carcinoma. The SCC Ag measurement raised the percentage of patients with elevated blood levels of an antigen from 57 percent to 71 percent. Elevated CEA or SCC Ag was an adverse prognostic indicator for squamous lung cancer, though the statistical significance was marginal. Whether this information may be used advantageously in the treatment of patients remains to be seen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Tumor antigens, CEA (Oncology), Carcinoembryonic antigen, Squamous cell carcinoma antigen

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