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The Value of Serum Tumour Markers: Carcinoembryonic Antigen, Alpha-Fetoprotein & Ferritin Estimation In Bronchogenic Carcinoma.
L.A. Banawan*, A. A. Darwish**, A.H. Hassab***, E.Gouda*, M.A. Abou Rayan*.
Departments of Chest Diseases* and Clinical Pathology, ***Alexandria and Menofia** Universities, Egypt.

Serum carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and ferritin were assessed in 74 subjects; 46 patients with confirmed lung cancer, 10 healthy heavy smokers, 10 patients with chronic obstructive pulmonary disease (COPD), 9 patients with pulmonary T.B., 9 patients with interstitial pulmonary fibrosis (I.P.F) and 10 normal healthy volunteers, to determine the usefulness of their estimation in the detection of lung cancer and to evaluate their sensitivity, specificity and diagnostic efficiency in lung cancer patients. Results of the present study revealed that there was no statistically significant difference in CEA serum level among the compared groups. CEA had sensitivity of 38,46%, positive predictive value (PPV) of 62.5%, negative predictive value (NPV) of 72.4% and diagnostic efficiency (DE) of 70.3%. AFP showed a statistically significant difference between patients with lung cancer and normal subjects. On the other hand, the difference in AFP serum level between patients with lung cancer and the other subgroups was not significant. The sensitivity of AFP in discriminating between lung cancer patients and benign lung disease was low 38,46%, its specificity was 62.5%, PPV 35.7%, NPV was 65.2% and its DE was 54.1 % .There was a highly significant difference in serum ferritin level between patients with lung cancer and the other tested groups. Ferritin seems to be relatively the most effective indicator for the presence of lung cancer versus normal population & other benign lung diseases. Ferritin sensitivity in diagnosing lung cancer was 76.92%, specificity was 91.7%, PPV was 83.3%, NPV 88% and DE 86.5%. The present study revealed that non of the markers tested showed a relation to the pathological type of the disease. Ferritin serum level was significantly higher in patients with metastasis. Because of some false negative and positive results, determination of tumour marker levels should be used only in context with other clinical and laboratory findings to improve their diagnostic yield. They are more suitable for early detection of recurrence after surgery & detection of undiagnosed metastasis or residual neoplastic tissue.

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Copyright 2002 Egyptian Association of Immunologists .
Last modified: January 21, 2003 .