[Usefulness of carcinoembryonic antigen and other markers in patients with hemoptysis].

Objective: We have examined the carcinoembryonic antigen (CEA) and other tumor markers (immunoglobulins, CA 19.9, LDH, alpha-fetoprotein and alpha-1-antitrypsin) with the purpose of recognize their utility in patients with hemoptysis and patients older than 45 years with a positive smoking history and hemoptysis.
Methods: We measured, analyzed and compared these markers in 336 patients with a known etiology of hemoptysis divided in group I (malignant etiology) with 101 cases (30.1%) and II (nonmalignant) with 235 cases (69.9%) (p < 0.001).
Results and Conclusions: The values of CEA, LDH and CA 19.9 were increased in group I, without differences when we compared immunoglobulins (G, A and M), alpha-fetoprotein and alpha-1-antitrypsin in both groups. CEA and LDH were increased significantly according to the disease extent in nonsmall cell lung carcinoma. Smokers had an increased CEA only in group II. Plasma values of CEA higher than 5 ng/mL meant that the likelihood of bronchial carcinoma was high. Our markers proved to be more specific and with a high positive or negative predictive values than sensitives. These results would suggest that they are not of great help for early diagnosis of lung cancer, however an increase of CEA, LDH and CA 19.9 plasma concentrations could suggest with high probability a bronchial carcinoma, improving their diagnostic sensibility when we used them in combination.