Analysis of CEA Expression and EGFR Mutation Status in Non-small Cell Lung Cancers

Abstract

Background: The serum carcinoembryonic antigen (CEA) level can reflect tumor growth, recurrence and metastasis. It has been reported that epidermal growth factor receptor (EGFR) mutations in exons 19 and 21may have an important relationship with tumor cell sensitivity to EGFR -TKI therapy. In this study, we investigated the clinical value of EGFR mutations and serum CEA in patients with non-small cell lung cancer (NSCLC). Materials and Methods:The presence of mutations in EGFR exons 19 and 21 in the tissue samples of 315 patients with NSCLC was detected with real-time fluorescent PCR technology, while the serum CEA level in cases who had not yet undergone surgery, radiotherapy, chemotherapy and targeted therapy were assessed by electrochemical luminescence. Results: The mutation rates in EGFR exons 19 and 21 were 23.2% and 14.9%, respectively, with the two combined in 3.81%. Measured prior to the start of surgery, radiotherapy, chemotherapy and targeted treatment, serum CEA levels were abnormally high in 54.3% of the patients. In those with a serum CEA level <5 ng/mL, the EGFR mutation rate was 18.8%, while with 5~19 ng/mL and ≥20 ng/mL, the rates were 36.4% and 62.5%. In addition, in the cohort of patients with the CEA level being 20~49 ng/mL, the EGFR mutation rate was 85.7%, while in those with the CEA level ≥50 ng/mL, the EGFR mutation rate was only 20.0%, approximately the same as in cases with the CEA level<5 ng/mL. Conclusions: There is a positive correlation between serum CEA expression level and EGFR mutation status in NSCLC patients, namely the EGFR mutation-positive rate increases as the serum CEA expression level rises within a certain range (≥20 ng/mL, especially 20~49 ng/mL). If patient samples are not suitable for EGFR mutation testing, or cannot be obtained at all, testing serum CEA levels might be a simple and easy screening method. Hence, for the NSCLC patients with high serum CEA level (≥20 ng/mL, especially 20~49 ng/mL), it is worthy of attempting EGFR-TKI treatment, which may achieve better clinical efficacy and quality of life.

Usefulness of carcinoembryonic antigen in the diagnosis of small cell lung cancer combined with adenocarcinoma

“…15,[17][18][19] In this study, a CEA cut-off of 5 ng/mL was not found to be useful for distinguishing SCLC combined with adenocarcinoma from pure SCLC. This may be because most of our patients had a history of cigarette smoking, and serum CEA levels are known to be elevated in smokers.…”

Correlation between pre‐treatment serum carcinoembryonic antigen levels and genotypes in a large population of Chinese people with advanced lung adenocarcinoma

“…These findings raise the question of whether there is any correlation between serum CEA levels and EGFR gene mutations. It has been reported that there is a positive correlation between serum CEA expression levels and EGFR mutation status in non‐small‐cell lung cancer (NSCLC) patients . However, whether CEA levels are associated with lung tumour genotypes, especially those rare EGFR mutations and ALK gene rearrangements, remain largely unclear.…”

Prediction of Lung Cancer Based on Serum Biomarkers by Gene Expression Programming Methods

“…Markers which have been widely used for diagnosing lung cancer include CEA (Yang et al, 2014), Cyfra21-1 (Tomita et al, 2010), NES (Chu et al, 2011), LDH (Ziaian et al, 2014), CRP (Onitilo et al, 2012) and other indexes. However, single marker of lung cancer shows low diagnostic specificity and sensitivity, having poor value for the diagnosis of lung cancer (Leidinger et al, 2010).…”