Objective. The aim of the present study was to define the usefulness of a urine tumor marker, di-acetylspermine (DiAcSpm) in patients with lung cancer. Materials and Methods. Of the patients who were treated for lung cancer from August 2003 to September 2010 in our hospital, 308 (non-small cell lung cancer-296, small cell lung cancer-12) were enrolled in this study. We compared the urine tumor marker, DiAcSpm with serum tumor markers (CEA, CYFRA21-1 and Pro-GRP). Besults. The sensitivity of urine DiAcSpm (46.4%) was significantly higher than that of serum CEA (32.7%) and serum CYFRA21-1 (23.7%). The specificity of urine DiAcSpm (90.6%) was similar to that of serum CEA (87.5%) and serum CYFRA21-1 (93.8%). We then compared the sensitivities of DiAcSpm and other markers among subjects according to tumor stage. The sensitivity of DiAcSpm was higher than that of CYFRA21-1 in Stage IA and IB patients, and CEA in Stage IIIB and IV patients, while the proportion of positive results for each marker increased with progression of the cancer. In particular, DiAcSpm was markedly elevated in 25.5% and 42.6% of Stage IA and IB patients, respectively, whereas only 5.4% and 18.5% of these patients were CYFRA21-1-positive, respectively. Pathologically, the sensitivity of urine DiAcSpm was markedly higher in patients with adenocarcinoma (39.5%) compared to CYFRA21-1 (17.3%), and in squamous cell carcinoma (62.0%) compared with CEA (33.3%) and SCC antigen (49.0%). Conclusion. These results suggest that urine DiAcSpm is useful as a tumor marker for lung cancer, because it is more sensitive than the serum markers currently in clinical use.
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