Elevation Of Tumor Markers In Cerebrospinal Fluid With Meningeal Carcinomatosis

MC was a special kind of malignant tumor transferred to nervous system, which needed CSF cytological examination to make a definite diagnosis. While the CSF cytological examination had low masculine, couldn't make use of early diagnosis. The abroad paper had reported that tumor markers in cerebrospinal fluid could make early diagnosis for MC. But it hadn't made control study. This study analyzed tumor markers in cerebrospinal fluid of MC and investigated its diagnosis value. ObjectiveTo summarize the tumor markers in cerebrospinal fluid with meningeal carcinomatosis. Methods1. We selected 116 patients who was admitted to our department from 1989 to 2007 and established three experiment groups. Group one was 21 MC patients. Group two was 72 TBM patients. Group three was 23 PIT patients. The diagnosis were made by clinical manifestation and auxiliary examination. All examples were gathered in define time.2. Tumor markers were measured by Roche E170 electrochemiluminescence analysator and its standard kit.3.Enumeration data was indicated with percentage. Mormal distribution measurement data was indicated with mean and standard deviation. Skewness distribution measurement data was indicated with median and interquartile range. Blood and CSF tumor markers were analyzed by Kruskal-Wallis H test in three groups. Correlation of CSF tumor markers and MC were analyzed by Spearman rank correlation. P<0.05 were thought as the Standard of statistical significance. SPSS for Windows 11.0 statistics software were used.Results1. The age was significant higher in MC group (51.00+10.00 year) than TBM(33.50+22.75 year, PIT 38.00+29.50year) . The course of MC was significant shorter than PIT (5.00+10.50 month) and was no statistics difference with TBM (1.50+2.50 month ) . The gender in three groups was nostatistics difference (P>0.05) .2. They were significant lower in MC group (intracranial pressure 270.00+120.00 mmH₂O,total cellular score 30.00+230.00×10⁶/L,white blood cell10.00+12.00×10⁶/L,glucose 2.08+0.75mmol/L and protein 509.20+526.50mg/L) thanTBMgroup(200.00+112.50mmH₂O,250.00+401.00×10⁶/L,l 14.50+250.00× 10⁶/L,2.45+1.13mmol/Land1000.00+1064.00mg/L). They were significant higherinMCgroup(intracranialpressure270.00+120.00mmH₂O,protein509.20+5 26.50mg/L)thanPITgroup(140.00+35.00 mmH₂O and 272.00+415.00 mg/L) while significant lower in glucose and chloride (2.08+0.75mmol/L and 121.00+7.50mmol/L)thanPITgroup(3.46+1.36mmol/Land122.10+6.15mmol/L)3. The CSF tumor markers were significant higher in MC group (CEA 76.77+199.69 ug/l,CA125 2.65+200.16 u/ml and CYFRA21-1 3.72+9.62 ng/ml) than the other two groups (TBM 0.32+0.32ug/1,1.83+1.08u/ml and 0.63+0.26ng/ml;PIT 0.20+0.34ug/l,1.85+1.19u/ml and 0.62+0.14ng/ml) .They were significant higher in MC group(CA153 2.66+4.05u/ml and CA199 1.89+5.29u/ml) than PIT group (1.17+0.29 u/ml and 0.60+0.10 u/ml) .4.The serum tumor markers were significant higher in MC group(CEA 54.26+251.55 ug/l,CA125 38.56+75.56 u/ml and CA199 25.42+15.44 u/ml) than the other two groups(TBM 1.98+1.64 ug/1 ,14.4+14.97u/ml and 7.90+3.38u/ml; PIT 2.09+1.75ug/1,15.78+8.42u/ml and 10.61+3.82 u/ml) . They were significant higher in MC group(CA153 15.92+19.26 u/ml and AFP 3.21+2.34ug/1) than PIT group (10.67+5.69u/ml and 1.90+1.33 ug/1) .5.CSF tumor markers including CEA, CA125, CA153, CA724 and CYFRA21-1 were positive correlation with serum tumor markers (P<0.05) ,the correlation coefficient were 0.6173,0.5789,0.7055,0.9949 and 0.7677. CA199 werepositive correlation with course of disease (P < 0.05 ), the correlation coefficient were 0.5845. Age were no correlation with other index (P > 0.05) .6.The CSF tumor markers were significant higher in adenocarcinomaMC(CEA76.77+206.15ug/landCA1534.65+4.42u/ml)than non-adenocarcinomaMC (81.25+135.30ug/l and 1.00+0.96u/ml) .7.There were no significant difference in serum tumor markers between adenocarcinoma MC and non-adenocarcinoma MC (P>0.05) .ConclusionsCSF tumor markers could make early diagnosis for MC. especially were CEA, CA125, CA199 and CYFRA21-1. CEA and CA153 were valuable in histotype. It was positive correlation with serum tumor markers including CEA, CA125 and CYFRA21-1. CA199 were positive correlation with course of disease.