[The role of tumor markers in the pre-therapeutic staging of non-small cell bronchial cancer].

A biological cancer marker is a molecule, synthetized from a neoplastic tissue, which is present in the tumor and can be detected in measurable amounts in circulating blood. The natural history, prognosis, heterogeneity of each tumor and the histology of bronchial cancers clearly show the difficulty to establish the role of markers in the management of these tumors, especially for the initial assessment of extension. The analysis of the literature shows that studies on this subject are rare. The use of an isolate marker is not sufficient for a positive diagnosis of non-small-cell bronchial cancer. The use of several markers produces better results. However, no model is accurate enough to formally influence the diagnosis of operability. No isolate or associated marker allows differentiating between small-cell and non-small-cell bronchial cancers. The most interesting two markers finally seem to be ACE and CA 125. All other markers must not be used as a routine during the assessment of non-small-cell bronchial cancers. However, these markers are still important for therapeutic follow-up. Even though they are not predictive of chemosensitivity, and even though their decrease is not regarded as an objective criterion of response, their variations are linked with the response to chemotherapy, and their persistent normalization after surgery is compatible with apparent complete remission. The ACE and CA 125 assays can therefore be used as a reference, in case of initial positive findings, for the subsequent follow-up of the patient.