Συμβολή στην ανίχνευση και μελέτη των ορολογικών καρκινικών δεικτών σε ασθενείς με καρκίνο κεφαλής ή τραχήλου

Abstract

Objective. The identification of a reliable circulating tumor marker in squamous cell carcinoma of the head and neck (SCCHN) could assist in early diagnosis and monitoring response to therapy. The aim of this study was to investigate the effectiveness of the serum tumor markers Cyfra 21-1, TPA-M, SCCA and CEA. Study design. Serum levels of Cyfra 21-1, TPA-M, SCCA and CEA were measured in 136 patients with a histologically proven SCCHN before and after treatment and in 125 healthy subjects, as controls. We tried to evaluate the sensitivity and specificity of these tumor markers and to correlate their levels with tumor staging, grading or performance status. Immunohistochemical study of CK 8, 18 and 19 in a group of 44 patients suffering from SCC of Rhinopharynx was also performed. An effort was made to correlate IHC overexpression of CK19 with high serum levels of CYFRA 21-1. Results. The study showed that none of the above markers presented satisfactory specificity and sensitivity in early diagnosis. In comparison with the other markers. TPA-M was the most effective of all markers and indicated a positive correlation with the grade of differentiation and nodal status. It has been investigated a remarkable correlation between high levels of TPA-M and CYFRA 21-1 in advanced stages (III, IV) of cancer. No correlation was found between IHC of the three CKs, either between serum and tissue overexpression of CK19. Conclusions. All the tumor markers that were studied have significant limitations in the early diagnosis of cancer, but TPA-M and CYFRA 21-1 may have a role in monitoring the success of therapy and follow up of patients with SCCHN.