Prognostic value of the tissue polypeptide antigen in lung cancer

The prognostic impact of TPA was evaluated by assaying the marker in the serum of 563 patients with a newly diagnosed bronchogenic carcinoma. The group included patients with squamous cell cancers and others with tumors of diverse or undefined histologies. Raised levels of TPA were clearly associated with a shortened survival, even adjusting for the stage of disease. A Cox's proportional hazards regression analysis, incorporating all major prognostic factors, selected TPA as an independent survival predictor. In the regression model, however, TPA was less important than disease extent, KPS and weight loss. Another multivariate analysis was made in a subgroup of 121 patients who, because of poor KPS or advanced age, had undergone a limited staging workup; TPA came out as the first most important factor. This study shows that TPA is an important prognostic factor and that it should be included among laboratory data evaluated in lung cancer studies.