Lowered Serum Testosterone Concentration Is Associated With Enhanced Inflammation and Worsened Lipid Profile in Men.

The negative relationship between testosterone and inflammatory cytokines has been reported for decades, although the exact mechanisms of their interactions are still not clear. At the same time, little is known about the relation between androgens and acute phase proteins. Therefore, in this investigation, we aimed to study the relationship between androgen status and inflammatory acute phase reactants in a group of men using multi-linear regression analysis. Venous blood samples were taken from 149 men ranging in age from 18 to 77 years. Gonadal androgens [testosterone (T) and free testosterone (fT)], acute phase reactants [C-reactive protein (CRP), ferritin (FER), alpha-1-acid glycoprotein (AAG), and interleukin-6 (IL-6)], cortisol (C), and lipid profile concentrations were determined. It was demonstrated that the markers of T and fT were negatively correlated with all acute phase proteins (CRP, FER, and AAG; p < 0.02) and the blood lipid profile [total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides (TG); p < 0.03]. Multivariate analysis showed that T, fT, and the fT/C ratio were inversely correlated with the CRP, AAG, and FER concentrations independently of age and blood lipids. When adjustment for BMI was made, T, fT, and the fT/C ratio were negatively correlated with the AAG concentrations only. In addition, it was demonstrated that gonadal androgens were positively correlated with physical activity level (p < 0.01). We have concluded that a lowered serum T concentration may promote inflammatory processes independently of adipose tissue and age through a reduced inhibition of inflammatory cytokine synthesis, which leads to enhanced acute phase protein production. Therefore, a low serum T concentration appears to be an independent risk factor in the development of atherosclerosis and cardiovascular diseases. Moreover, the positive correlation between testosterone and physical activity level suggests that exercise training attenuates the age-related decrease in gonadal androgens and, in this way, may reduce the enhancement of systemic low-grade inflammation in aging men.

Pro-gastrin-releasing peptide (ProGRP) as a biomarker in small-cell lung cancer diagnosis, monitoring and evaluation of treatment response.

Lung cancer belongs to malignant tumors that possess the highest rates of morbidity and mortality in the world. A number of morphological, biological and clinical features justify the distinction of small-cell carcinoma with respect to the other histological types of lung cancer. The predominant neuroendocrine phenotype is critical for the selection of biomarkers used in diagnostics, monitoring and evaluation of treatment response; early onset relapses in patients with small-cell lung cancer (SCLC) and the evaluation of their prognosis. Although for a long time the neuron-specific enolase (NSE) was considered to be the marker of choice for this tumor, it is now increasingly important to pay attention to concentrations of pro-gastrin-releasing peptide (ProGRP). The results of this marker have been implicated in the differential diagnosis of non-small lung cancer and SCLC, chemotherapy and radiotherapy monitoring as well as evaluation of treatment response. The subject of this series of studies is to determine the usefulness of ProGRP in the evaluation of patients' prognosis and its predictive value. The current aim for the optimization of the effectiveness of biochemical diagnostics of SCLC is recommended by complementary ProGRP and NSE studies. The present work is a summary of the latest reports regarding diagnostic utility of these markers in SCLC.

Human Epididymis Protein 4 (HE4) in Patients with Small-Cell Lung Cancer.

BACKGROUND: The aim of the present study was to compare the diagnostic utility of HE4 with NSE, ProGRP, CYFRA 21-1, CEA, and CA 125 and evaluate their prognostic value in patients with small-cell lung cancer (SCLC). METHODS: HE4, ProGRP, NSE, CYFRA 21-1, CEA, and CA 125 assays were performed in 63 patients with smallcell lung cancer (limited disease (LD) - 41, extensive disease (ED) - 22) and in 66 individuals of the reference group. RESULTS: Area under the ROC curves for HE4, ProGRP, NSE, CA 125, CYFRA 21-1, and CEA were 0.884, 0.923, 0.826, 0.796, 0.739, and 0.704, respectively. The tumor marker serum concentrations were associated with tumor stage (HE4, ProGRP, NSE, CYFRA 21-1, CEA), and disease progression occurred within one year (HE4, ProGRP, NSE, CYFRA 21-1). The tumor advancement, performance status, gender and tumor markers, except CEA and CA 125, were significantly associated with survival. Independent, unfavourable prognostic factors included extensive disease (HR 4.14, p < 0.0001) and NSE concentration above 35 g/l (HR 2.62, p = 0.0009). CONCLUSIONS: Diagnostic utility of HE4 was similar to that of NSE and ProGRP. Complementary to NSE, determination of HE4 seems to be helpful in evaluation of SCLC patients' prognosis.

Clinical Use of Cancer Biomarkers in Epithelial Ovarian Cancer: Updated Guidelines From the European Group on Tumor Markers.

OBJECTIVE: To present an update of the European Group on Tumor Markers guidelines for serum markers in epithelial ovarian cancer. METHODS: Systematic literature survey from 2008 to 2013. The articles were evaluated by level of evidence and strength of recommendation. RESULTS: Because of its low sensitivity (50-62% for early stage epithelial ovarian cancer) and limited specificity (94-98.5%), cancer antigen (CA) 125 (CA125) is not recommended as a screening test in asymptomatic women. The Risk of Malignancy Index, which includes CA125, transvaginal ultrasound, and menopausal status, is recommended for the differential diagnosis of a pelvic mass. Because human epididymis protein 4 has been reported to have superior specificity to CA125, especially in premenopausal women, it may be considered either alone or as part of the risk of ovarian malignancy algorithm, in the differential diagnosis of pelvic masses, especially in such women. CA125 should be used to monitor response to first-line chemotherapy using the previously published criteria of the Gynecological Cancer Intergroup, that is, at least a 50% reduction of a pretreatment sample of 70 kU/L or greater. The value of CA125 in posttherapy surveillance is less clear. Although a prospective randomized trial concluded that early administration of chemotherapy based on increasing CA125 levels had no effect on survival, European Group on Tumor Markers state that monitoring with CA125 in this situation should occur, especially if the patient is a candidate for secondary cytoreductive surgery. CONCLUSIONS: At present, CA125 remains the most important biomarker for epithelial ovarian cancer, excluding tumors of mucinous origin.

Changes in Biochemical Properties of the Blood in Winter Swimmers.

The aim of the study was to investigate the effects of winter swimming on biochemical indicators of the blood. The subjects - winter swimmers - belonged to the Krakow Walrus Club "Kaloryfer" - "The Heater". The study group consisted of 11 men, aged 30-50 years, 'walrusing' throughout the whole season from November to March. Statistically significant changes throughout the 'walrusing' season were observed for the following biochemical parameters: a decrease in sodium (mmol/1), chloride (mmol/1), alpha-2 globulin(g/1), gamma globulin (g/1), IgG (g/1), and an increase in albumin (g/1), indicator A/G, IgA (g/l ), Herpes simplex virus IgM. Seasonal effort of winter swimmers has a positive influence on biochemical blood parameters.

Changes in the clinical characteristics, treatment options, and therapy outcomes in patients with phyllodes tumor of the breast during 55 years of experience.

BACKGROUND: Data from the literature suggests that the clinical picture of phyllodes tumor (PT) of the breast, as well as treatment options and perhaps therapy outcomes, have significantly changed. The aim of this work was to review these changes by analysis of consecutive patients with PT over a 55-year period at a single institution. MATERIAL AND METHODS: From 1952 to 2007, 280 women with PT were treated surgically at the Maria Sklodowska-Curie Memorial Institute of Oncology, Cancer Center in Cracow. Age, size of breast tumor, microscopic type, extent of surgery, and therapy outcomes were compared between 2 groups: 190 patients treated from 1952 to 1991 vs 90 patients treated from 1992 to 2007. RESULTS: The results show that the 1992-2007 group compared to the 1952-1991 included more patients <50 years of age, with tumor <5 cm in diameter, undergoing breast-conserving therapy, as well as no evidence of disease at 5-year survival had increased and this change was statistically significant. In addition, malignant PT cases had decreased in frequency. CONCLUSIONS: The results of this study show that patients with PT are increasingly younger, the breast tumors at diagnosis are smaller, malignant PT is becoming less frequent, and BCT is now the treatment of choice. Most importantly, the general treatment outcomes are significantly better.

Preoperative radiotherapy does not alter pre- and early postoperative serum C-reactive protein and albumin concentrations in colorectal cancer patients.

AIM OF THE STUDY: We aimed to assess the alterations of serum C-reactive protein (CRP) and albumin levels in colorectal cancer patients who underwent preoperative radio(chemo)therapy and those who did not. MATERIAL AND METHODS: The determinations of albumin and CRP were performed before and at 2, 3, 5 and 7 days after surgery in 60 colorectal cancer patients. 25 healthy subjects served as a reference group. For each patient the modified Glasgow Prognostic Score (mGPS) was calculated. RESULTS: On the operation day CRP and albumin concentrations were not different in preoperatively treated or radiotherapy naïve patients. On postoperative day 2, 3, 5 and 7 no significant differences were observed between the two groups, with the only exception for albumin concentration, which was significantly higher on postoperative days 2 and 7 in the radiation naïve group. In all patients perioperative alterations of serum CRP level were significant at all time points (preoperatively vs. day 2, day 2 vs. day 3, day 3 vs. day 5, day 5 vs. day 7). The albumin decrease from the preoperative day to postoperative day 2 was significant, as was its increase from postoperative day 3 to 5. CONCLUSIONS: We have seen no differences in the CRP and albumin concentrations in preoperatively irradiated versus non-irradiated colorectal cancer patients on the day of surgery and on postoperative days 2, 3, 5 and 7. There were, however, significant concentration changes in the value of these two serum markers from preoperatively to postoperative day 2 and over the following postoperative week, but presumably related to the surgical trauma, not the neoadjuvant treatment.

Skeletal muscle myosin heavy chain isoform content in relation to gonadal hormones and anabolic-catabolic balance in trained and untrained men.

Gonadal hormones and anabolic-catabolic hormone balance have potent influence on skeletal muscle tissue, but little is known about their action with regard to myosin heavy chain (MHC) transformation in humans. We investigated the relationship between skeletal muscle MHC isoform content in the vastus lateralis muscle and basal testosterone (T) concentration in 3 groups of subjects: endurance trained (E), sprint/strength trained (S), and untrained (U) young men. We have also determined basal sex hormone-binding globulin and cortisol (C) concentrations in untrained subjects to examine the relationship between MHC composition and the anabolic-catabolic hormone balance. Moreover, basal free testosterone (fT) and bioavailable testosterone (bio-T) concentrations were calculated for this subgroup. Despite significant differences in MHC isoform content (69.4 ± 2.39%, 61.4 ± 8.04%, and 37.5 ± 13.80% of MHC-2 for groups S, U, and E, respectively, Kruskal-Wallis: H = 18.58, p < 0.001), the T concentration was similar in the three groups of subjects (18.84 ± 5.73 nmol·L(-1), 18.60 ± 5.73 nmol·L(-1), and 20.73 ± 4.06 nmol·L(-1) for U, E, and S groups, respectively, Kruskal-Wallis: H = 1.11, p > 0.5). We have also found that in the U group, type 2 MHC in the vastus lateralis muscle is positively correlated with basal fT:C ratio (r = 0.63, p = 0.01). It is concluded that the differences in the training history and training specificity can be distinguished with regard to the MHC composition but not with regard to the basal T concentration. Simultaneously, it has been shown that MHC isoform content in human vastus lateralis muscle may be related to basal anabolic-catabolic hormone balance, and this hypothesis needs further investigation.

Hemodialysis decreases serum brain-derived neurotrophic factor concentration in humans.

In the present study we have evaluated the effect of a single hemodialysis session on the brain-derived neurotrophic factor levels in plasma [BDNF](pl) and in serum [BDNF](s) as well as on the plasma isoprostanes concentration [F(2) isoprostanes](pl), plasma total antioxidant capacity (TAC) and plasma cortisol levels in chronic kidney disease patients. Twenty male patients (age 69.8 ± 2.9 years (mean ± SE)) with end-stage renal disease undergoing maintenance hemodialysis on regular dialysis treatment for 15-71 months participated in this study. A single hemodialysis session, lasting 4.2 ± 0.1 h, resulted in a decrease (P = 0.014) in [BDNF](s) by ~42 % (2,574 ± 322 vs. 1,492 ± 327 pg ml(-1)). This was accompanied by an increase (P < 10(-4)) of [F(2)-Isoprostanes](pl) (38 ± 3 vs. 116 ± 16 pg ml(-1)), decrease (P < 10(-4)) in TAC (1,483 ± 41 vs. 983 ± 35 trolox equivalents, µmol l(-1)) and a decrease (P = 0.004) in plasma cortisol level (449.5 ± 101.2 vs. 315.3 ± 196.3 nmol l(-1)). No changes (P > 0.05) in [BDNF](pl) and the platelets count were observed after a single dialysis session. Furthermore, basal [BDNF](s) in the chronic kidney disease patients was significantly lower (P = 0.03) when compared to the age-matched control group (n = 23). We have concluded that the observed decrease in serum BDNF level after hemodialysis accompanied by elevated [F(2)-Isoprostanes](pl) and decreased plasma TAC might be caused by enhanced oxidative stress induced by hemodialysis.

Gonadal hormone status in highly trained sprinters and in untrained men.

It is a common view that strength and sprint trained athletes are characterized by high plasma/serum testosterone (T) concentration, which is believed to be partly responsible for their performance level. This opinion, however, has poor scientific background. The aim of this study was to give evidence-based information on this issue. We examined gonadal hormone status at rest after overnight fasting in high and top-class track and field sprinters (n = 16) and in untrained men (n = 15). It was shown that basal T, free testosterone (fT), bioavailable testosterone (bio-T), and sex hormone-binding globulin concentrations were not significantly different (p > 0.05) in sprinters vs. untrained subjects. Further comparison of the results of the basal serum T concentration in 8 sprinters showed its significant changes during an annual training period. Significantly higher T concentration during a low-intensity training period (beginning of December) than during heavy sprint specific training period (end of March) was observed in these athletes (n = 8) (mean ± SD; 23.37 ± 5.28 vs. 20.99 ± 4.74 nmol · L(-1), respectively, p = 0.04). We have concluded that basal gonadal hormone concentration in high and top-class athletes (sprinters and jumpers) did not appear to be significantly different when compared with untrained subjects. Moreover, basal T concentration in sprinters can differ significantly during an annual training period. This fact should be taken into consideration when interpreting the results of gonadal hormone status in athletes at varied training stages.

Utility of ProGRP determinations in cancer patients.

BACKGROUND: The aim of this study was to assess the utility of ProGRP determinations in patients with selected cancer localization, during and after therapy. MATERIALS AND METHODS: The study involved a reference group and a population of lung, breast, ovarian, and prostate cancer patients. ProGRP was evaluated using two-step chemiluminescent microparticle immunoassay (CMIA) manufactured by Abbott Diagnostics, and Architect i2000 analyzer. RESULTS: During follow-up of SCLC patients, an increased value for ProGRP was found in 51% and for NSE only in 25.5% of the patients, whereas in NSCLC patients, percentages with elevated ProGRP and CYFRA 21-1 were 8.6% and 55.7%, respectively. SCLC patients also had the highest AUC values for ProGRP. In other cancers, the frequency of elevated ProGRP results were as follows: 13.1%--in breast cancer patients, 19.6%--in ovarian cancer patients, and 15.1%--in prostate cancer patients. CONCLUSIONS: The presented study revealed that ProGRP is a tumor marker of choice in SCLC, because of its high diagnostic specificity in relation to the reference group and to the group with other malignancies.

IL-6 and VEGF in small cell lung cancer patients.

Recent data suggest a link between chronic inflammation, angiogenesis, and the development of cancer. The aim of this study was the evaluation of serum IL-6 and VEGF in comparison with the tumor markers NSE and ProGRP, with respect to the prognosis of small cell lung cancer patients. The study of IL-6, VEGF, NSE, ProGRP and platelet count was performed in a group of 72 patients with previously untreated small cell lung cancer at different stages of disease: 40 with limited and 32 with extensive disease. Significantly higher IL-6 and VEGF concentrations and platelet count, as well as NSE and ProGRP levels, were found in patients with small cell lung cancer in comparison with the reference group. Patients with extensive cancer had significantly higher levels of IL-6, VEGF, NSE and ProGRP than those with limited cancer. Elevated VEGF levels, with no significant differences in frequency of elevated NSE and ProGRP concentrations, were often observed in patients with IL-6 levels higher than 5.1 ng/l. Univariate analysis confirmed a significant relationship not only between overall survival and stage of disease or gender, but also with VEGF, IL-6, NSE and ProGRP levels. Moreover, multivariate analysis revealed that only the extent of the disease and IL-6 may be independent prognostic factors in the group of small cell lung cancer patients under investigation. However, simultaneous determinations of ProGRP and IL-6, as well as ProGRP and VEGF, in addition to the extent of the disease, may serve as additional, independent prognostic factors in small cell lung cancer.

[Prognostic value of laboratory factors of performance status in lung cancer patients]. / Wartosc prognostyczna laboratoryjnych wykladników stanu ogólnego u chorych na raka pluca.

Clinical observations indicate that the utility of classical prognostic factors in the assessment of probability of disease free or overall survival of lung cancer patients is not completely satisfactory. This is the cause for search of indices which results would contribute to optimization of this estimation. Of potential value in this aspect may also be the results of laboratory determinations which characterize patient's performance status. Dependencies between the times of overall survival in respect to chosen hematological and biochemical factors from the pretreatment period were analyzed in a group of 233 patients with lung cancer (adenocarcinoma - 44, squamous cell lung cancer - 156, small cell lung cancer - 33 patients) in different stages of disease. Apart from stage of disease and histological type of tumor, independent prognostic factors turned out to be the actual ideal body mass ratio and the number of leucocytes. In patients with less advanced stages of disease, such independent factors, apart from histological type are alpha-1 globulin and gamma globulin.

ProGRP and NSE in therapy monitoring in patients with small cell lung cancer.

The usefulness of serum pro-gastrin-releasing peptide (ProGRP) as a tumor marker in patients with small cell lung cancer has recently drawn the attention of many research centers. The aim of the study was the evaluation of ProGRP, neuron-specific enolase (NSE), soluble fragment of cytokeratin 19 (CYFRA 21-1) and lactate dehydrogenase (LDH) levels at the time of diagnosis and during chemo- and radiotherapy of small cell lung cancer patients with limited disease (SCLC-LD). The studies were performed on a group of 64 patients with SCLC-LD who had received no prior therapy. All the patients were given the same treatment regimen. ProGRP, NSE, CYFRA 21-1 and LDH were measured before each course of chemotherapy and then at 3 and 6 months after the end of treatment. Prior to therapy, elevated levels of ProGRP, NSE, CYFRA 21-1 and LDH were found in 79.7%, 57.8%, 23.4%, and 12.5% of the patients respectively. Before the second chemotherapy course, all the tumor marker levels except LDH decreased significantly in comparison with the pretreatment concentrations. However, only ProGRP levels showed a progressive drop during consecutive courses of therapy, while NSE and CYFRA 21-1 fluctuated within reference ranges. When the study group was divided with respect to the effect of treatment evaluated six months from its termination, significant differences in ProGRP levels were found between both subgroups throughout all therapy and follow-up, except for the fifth course of chemotherapy. Differences in NSE levels were only significant for the first two courses and follow-up. Univariate analysis showed significant relationships between disease-free survival and the initial levels of NSE and CYFRA 21-1 as well as between overall survival and prophylactic cranial irradiation (PCI) and the initial ProGRP, NSE and CYFRA 21-1 levels. Changes of ProGRP level seem to be more precise than NSE as a tool for monitoring therapy in SCLC patients with limited disease, but for prediction of relapse, in addition to NSE determinations of ProGRP seem to be optimal.

[Effect of incremental cycling exercise performed before and 24 hours after blood withdrawal on the concentration of morphologic elements of blood in young health men]. / Wplyw jednorazowego intensywnego wysilku fizycznego, wykonanego przed i po upuscie krwi, na poziom wybranych wskazników hematologicznych u mlodych, zdrowych mezczyzn.

The aim of this study was to evaluate the effect of incremental cycling exercise test performed before and 24 hours after blood donation (withdrawal of 450 ml of blood) on the plasma volume and concentration of morphologic elements of blood. Thirteen subjects (mean +/- SD), age 23 +/- 3 years; body mass 75 +/- 10 kg; BMI 23.4 +/- 2 kg x m(-2); VO2max 2903 +/- 334 ml x min(-1), volunteered for this study. The exercise test started at the power output of 20 W with an increase by 20 W every 3 minutes--until exhaustion. This test was performed once in the control study (7-12 days before blood donation) and repeated 24 hrs after blood donation. The blood samples were taken from the antecubital vein, in a sitting position (1) at rest, (2) at the stage of 100 W power output, (3) at the end of the test (the stage of exhaustion) and (4) at 2 hours after the end of the test. The changes in plasma volume were evaluated according to changes in hemoglobin and hematocrit concentrations. The significance of differences in the studied variables were tested using Wilcoxon test. At the end of the exercise test a significant (p<0.05) decrease in plasma volume was found in both study. It amounted to--11.1 +/- 2.9% in the control study, and to--13.0 +/- 3.9% after blood donation. Within 2 hours after the end of the exercise test plasma volume returned to the pre-exercise value in the control study and exceeded the pre-exercise value by 3.9 +/- 6.7% (p<0.05) in the study performed after blood donation. The MCV, MCH, and MCHC values were not affected by the exercise performed before and after blood donation. In the control study, at the end of the incremental exercise test a significant increase in the leukocyte, lymphocyte and thrombocyte count was found. At 2 hours after exercise thrombocytes count returned to the pre-exercise level, whereas the exercise-induced leucocytosis remained at the end-exercise level. The lymphocyte count decreased to lymphopenic level. During the incremental exercise test performed after blood donation the changes in the concentration of the studied morphologic elements of blood were similar as in the control study. The only difference was noticed in the changes of lymphocyte count which returned to the pre-exercise level within 2 hours after exhaustion. Taking into consideration the changes in plasma volume it was found that during the incremental exercise tests (both in the control study and after blood donation) there was a significant (p<0.05) extra vascular escape of erythrocytes and thrombocytes. This was accompanied by a significant accumulation of neutrophils and lymphocytes in circulating blood. At 2 hours after the end of exercise, neutrophils count increases and lymphocytes migrate into peripheral lymphoid tissues, causing lymphopenia.

Biochemical diagnostics of bone metastases.

The skeleton is a frequent localization of cancer metastases. The method of choice in their diagnostics is scintigraphy, but at high sensitivity, it is characterized by limited diagnostic specificity. Discussed are the possibilities of using the examination of some tumor markers as well as biochemical factors of the resorption and bone formation process in bone metastases diagnostics. At the present stage, it can be found that the studies of such factors introduce a number of additional significant information, but they cannot fully replace bone scan.

[Effect of blood withdrawal on changes in plasma volume and protein concentration during incremental cycling exercise in men]. / Wplyw upustu krwi na zmiany objetosci osocza i stezenie bialek w surowicy u mlodych dawców krwi podczas intensywnego wysilku fizycznego.

The aim of this study was to evaluate the effect of blood withdrawal on the plasma volume and serum proteins concentration during incremental cycling exercise test performed 24 hours after blood donation (withdrawal of 450 ml of blood). Thirteen subjects (mean +/- SD), age 23 +/- 3 years; body mass 75 +/- 10 kg; BMI 23.4 +/- 2 kg.m-2; VO2max 2903 +/- 334 ml.min-1, performed an incremental cycling exercise test, starting at the power output of 20 W with an increase by 20 W every 3 minutes--until exhaustion. This test was performed twice: once in the control study (7-12 days before blood donation) and repeated 24 h after blood donation. The blood for this study was taken from the antecubital vein, in a sitting position at rest (6 minutes before the exercise test, at the end of the test (the stage of exhaustion) and 2 hours after the end of the test. The changes in plasma volume were evaluated on the basis of changes in hemoglobin and haematocrit concentrations. Significances of differences in the studied variables were tested using Wilcoxon test. At the end of the exercise test a significant (p < 0.05) decrease in plasma volume was found in both study. It amounted to -11.1 +/- 2.9% in the control study, and to -13.0 +/- 3.9% after blood donation. The difference in the changes in plasma volume in both tests was not significant. In the control study plasma volume return to the pre-exercise value within 2 hours after the end of the exercise test. In the study performed after blood donation the values of plasma volume exceeded the control value by 3.9 +/- 6.7% (p < 0.05) within 2 hours after finishing the exercise test. Taking into consideration the changes in plasma volume it was found that during incremental exercise there is a significant (p < 0.05) extra vascular escape of the serum proteins both in the control study, in case of total serum protein amounting to 4.05 +/- 2.97 g.l-1 as well as during exercise performed after blood donation, amounting to 5.49 +/- 3.98 g.l-1. Moreover, it was found that in the control study all the measured serum proteins concentrations (albumin, alpha 1-, alpha 2-, beta-, and gamma-globulins) return to the pre-exercise level within 2 hours after the end of exercise, but in the study performed after blood donation a continuous extra vascular escape of some serum proteins (alpha 1-, alpha 2- and gamma-globulins) was observed.

Carcinoembryonic antigen, squamous cell carcinoma antigen, CYFRA 21-1, and neuron-specific enolase in squamous cell lung cancer patients.

BACKGROUND: Carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), and CYFRA 21-1 are the most useful markers for non-small cell lung cancer (NSCLC), but neuron-specific enolase (NSE) is a tumor maker of choice for SCLC. The determination of NSE in NSCLC could allow selection of patients with neuroendocrine features. NSCLC patients whose tumors have neuroendocrine properties may be more responsive to chemotherapy; however, these tumors have been reported to be more aggressive. Tumor markers are not suitable for diagnosis; their principal applications are in monitoring of therapy and prognosis. METHODS: Tumor markers were measured in 200 untreated patients with squamous cell lung cancer (SQC) and a reference group (n = 220; 124 healthy persons and 96 patients with nonmalignant lung disease). CEA and SCC-Ag were measured by microparticle enzyme immunoassays on Abbott AxSYM and IMx analyzers. CYFRA 21-1 and NSE were measured by electrochemiluminescence immunoassays on the Roche Elecsys 2010. RESULTS: CEA, SCC-Ag, CYFRA 21-1, and NSE were increased above the cutoffs in 26%, 32%, 67%, and 28% of tested patients, respectively. The area under the ROC curve for CYFRA 21-1 was higher than those for CEA, SCC-Ag, and NSE (SQC vs controls). CYFRA 21-1 and CEA were significantly higher in advanced SQC than in early stages of disease (P <0.0001 and P <0.0004, respectively). In multivariate analysis of survival, CYFRA 21-1 was an independent but nonspecific prognostic factor in the operable group of SQC patients, whereas NSE was an independent prognostic factor in the advanced stages of disease. CONCLUSION: CYFRA 21-1 is an independent prognostic factor in earlier stages and NSE in the advanced stages of SQC.