[The value of tumor markers in pulmonary tuberculosis]

In thoracic oncology, no tumor marker has yet shown sufficient sensitivity nor specificity to be usefull for lung cancer diagnosis. However, in some cases, monitoring of tumor marker blood levels provides useful evaluation of response to specific treatment and assessment of infracfinical tumor progression.

To determine the value of umor markers in pulmonary tuberculosis.

A prospective study was conducted in our department during 2 years 2005 through 2007. We included 40 men who presented confirmed pulmonary tuberculosis. Before starting antituberculous chemotherapy, serum assays were practiced for the following tumor markers: NSE, CA125, ACE and Cyfra 21.1.

Mean age was 37.12 years (17-81). The levels of NSE were high in 91.66% of cases with an average value of 29.22 microg/l (2.24 X normal). This highest sensitivity was superior to those of other tumor markers: 55.55% for CA125, 28.94% for ACE and 7.6% for Cyfra 21.1. Analysis of the levels of NSE according to age, tobacco consumption, delay of consultation, type of the pulmonary lesions and negativation delay in smear did not show any significant difference, whereas levels of CA125 were higher in bilateral lesions (P = 0.05).

The highest sensitivity of the NSE in pulmonary tuberculosis, with no neoplastic pathology could be interesting for diagnosis of smear negative tuberculosis, with small amounts of bacilli.