Preoperative plasma CEA levels were measured by radioimmunoassay for 149 patients with bronchogenic carcinoma. The data were used to determine the prognostic value of the CEA assay in these patients. The relationship of preoperative CEA levels with stage of disease, histology and resectability was also examined. All of the patients with CEA levels >6 ng/ml died in less than 3 years while all of the patients who survived 3 to 5 years had preoperative CEA levels ≤ 6 ng/ml. The CEA assay had no prognostic significance for patients with undifferentiated large or small cell carcinomas since all of the patients with undifferentiated large cell carcinoma had CEA levels ≤ 6.0 ng/ml and all of the patients with small cell carcinoma have died regardless of their initial preoperative plasma CEA value. The number of patients in these two histologic groups was small and perhaps the study of additional patients will show a critical CEA level for these patients as well. There was no correlation observed between CEA levels ≤ 6 ng/ml vs. >6 ng/ml and resectability of the primary tumor. The studies indicate, however, that preoperative CEA levels are of prognostic value in patients with epidermoid and adenocarcinoma who have values >6 ng/ml since all of these patients have died and all of the long term survivors had levels ≤ 6 ng/ml.

Immunoprofile studies consisting of the measurement of de novo sensitization with DNCB, skin testing with microbial antigens, WBC and differential blood cell counts, enumeration of peripheral blood T and B lymphocytes and stimulation of lymphocytes with the plant mitogens PHA, Con A, and PWM were performed prior to irradiation therapy for 141 patients with bronchogenic carcinoma. The data from these studies were examined, with the addition of the variables stage of disease, histologic type of tumor, age and sex, by multivariate analysis for correlation with survival. Although stage of disease was shown to be a significant factor in the survival of these patients, the results of this analysis indicate that significant additional information relative to survival may be obtained from the measurement of: (1) patients' response to DNCB; (2) response to skin test antigens; and (3) the proportion of peripheral T lymphocytes. There was little gain in survival forecasting efficiency with the addition of the remaining variables.