Clinical evaluation of the neurophysins as tumor markers in small cell lung cancer.

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Small cell carcinoma of the lung (SCCL) is frequently associated with the ectopic production of peptide hormones, some of which produce significant clinical and laboratory abnormalities in the patient. The syndromes of inappropriate production of antidiuretic hormone (SIADH) and the ectopic secretion of adrenocorticotropic hormone (ACTH) have been well described and occur in 5%–10% of patients suffering from this disease (Kato et al. 1969; Eagan et al. 1974; Lokich 1982). The development of sensitive radioimmunoassays for peptide hormones such as calcitonin, vasopressin, pro-opiomelanocortin and its metabolites (ACTH, lipotropin, B-endorphin), for the neurophysins, and for other proteins, such as carcinoembryonic antigen, neuron-specific enolase, and the BB isoenzyme of creatine kinase, have led to the detection of these substances in SCCL. These peptides and proteins have also been detected in other types of lung cancer, but both the frequency of detection and the quantitative levels are much higher in SCCL. Studies of cell lines of SCCL have contributed to an expansion of the list of hormones detectable in culture. Bombesin is detected in a large percentage of small cell culture lines and may be functioning in an autocrine role (Moody et al. 1981; Sorenson et al. 1982). However, elevated serum levels of bombesin are infrequent (Wood et al. 1982).