Influence of cardiopulmonary resuscitation on levels of tumor markers

Background

Tumor markers (TM) including alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA 15-3, and prostate-specific antigen (PSA) are serum markers for malignant diseases. Previous studies investigating the effect of acute and chronic inflammation, cardiopulmonary bypass surgery, and cardiopulmonary resuscitation (CPR) on levels of TM showed conflicting results. CPR may result in a profound inflammatory response and is frequently associated with severe tissue hypoperfusion. The present study investigated whether AFP, CEA, CA 15-3, and PSA are influenced by CPR.

Methods and results

AFP, CEA, CA 15-3, and PSA (only in male patients) were assessed immediately after hospital admission, 6 hours, 12 hours, and 2 days after prolonged CPR in eight male and 12 female patients. Serum levels of AFP, CEA, CA 15-3 did not change significantly after CPR. PSA levels increased significantly with a peak 48 hours after CPR (3.3 ± 3.1 and 28.3 ± 30.5 ng/ml for baseline and 48 hours levels, respectively; P < 0.001). AFP, CEA, CA 15-3, and PSA (in males) values above the normal range were observed in 0%, 13.8%, 3.8%, and 46.9% of all measurements, respectively. At least one value above the normal range was observed in 0%, 20%, 5%, and 75% of all patients for AFP, CEA, CA 15-3, and PSA (in males), respectively. Baseline values of AFP, CEA, CA 15-3, and PSA (in males) were above the normal range in 0%, 15%, 5%, and 10% of all patients, respectively. Levels for all markers did not differ significantly between survivors and nonsurvivors.

Conclusions

Prolonged CPR does not influence AFP, CEA, CA 15-3 serum levels, but is frequently associated with increases of PSA. Thus, in contrast to PSA, interpretation of AFP, CEA, CA 15-3 serum levels is not influenced by recent CPR.

Table 1 Mean (± standard deviation) serum levels of AFP, CEA, CA 15-3, and PSA