Persistently High Serum Carcinoembryonic Antigen Levels after Surgery Indicate Poor Prognosis in Patients with Stage I Non-Small-Cell Lung Cancer

Wang, Chien Ying; Huang, Mu Shun; Huang, Min Hsiung; Lee, Hui Chen; Hsu, Han Shui

doi:10.1016/j.jss.2010.04.039

Cited by 25 publications

(23 citation statements)

References 25 publications

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“…Serum carcinoembryonic antigen (CEA) levels are usually elevated in lung adenocarcinoma patients, constituting an effective and noninvasive method for the diagnosis of this malignancy 13,14. CEA levels are independently associated with EGFR gene mutations, and the frequency of ALK fusion gene among patients with a serum CEA concentration below 5 ng/mL seems to be higher than that of patients with a concentration above 5 ng/mL ( P =0.021) 15.…”

Section: Introductionmentioning

confidence: 99%

Preoperative serum carcinoembryonic antigen levels are associated with histologic subtype, EGFR mutations, and ALK fusion in patients with completely resected lung adenocarcinoma

Wang¹,

Yang²,

2017

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BackgroundSerum carcinoembryonic antigen (CEA) is often elevated in lung adenocarcinoma, but not in all patients. Meanwhile, epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) fusion protein are the main driving forces in lung adenocarcinoma. However, whether CEA levels are associated with histologic subtype, EGFR mutations, and ALK fusion remain largely unclear.MethodsPreoperative serum CEA levels, postoperative histologic subtypes, and statuses of EGFR mutations and ALK fusion protein were retrospectively assessed in 442 patients with completely resected lung adenocarcinoma treated from January 2014 to December 2015 at Zhejiang Cancer Hospital, People’s Republic of China.ResultsEGFR mutations were found in 69.9% (309/442) of lung adenocarcinoma patients, and ALK fusion protein in 4.5% (20/442). EGFR mutations occurred more frequently in the lepidic subtype (P=0.001). High preoperative serum CEA levels (CEA >20 ng/mL) were independently associated with EGFR mutations (P<0.001). Moreover, in patients with CEA levels of 21–49 ng/mL, the EGFR mutation rate was 88.2%, which was higher compared to those obtained in the other subgroups. In addition, all specimens were invasive adenocarcinoma, with lepidic (18.6%), papillary (15.4%), acinar (52.7%), solid (9.7%), micropapillary (3.2%), and mucinous predominant (0.4%) subtypes; CEA levels in patients with the solid subtype were higher than those of other histologic subtypes (P=0.001).ConclusionPreoperative serum CEA levels can serve as a reference marker to identify the histologic subtype, and EGFR mutation or ALK fusion protein status, in lung adenocarcinoma patients. Moreover, histological subtypes could also predict EGFR mutations.

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Section: Introductionmentioning

confidence: 99%

Preoperative serum carcinoembryonic antigen levels are associated with histologic subtype, EGFR mutations, and ALK fusion in patients with completely resected lung adenocarcinoma

Wang¹,

Yang²,

2017

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“…Serum CEA levels are invariably elevated in lung adenocarcinoma. 15,16 We, therefore, attempted to find a cut-off value of preoperative serum CEA level that would assist in the diagnosis of C-SCLC. As adenocarcinoma is a common additional component in C-SCLC, our research focused on evaluating the usefulness of preoperative serum CEA levels in the diagnosis of SCLC combined with adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…Many researchers have reported that CEA can also be used as a prognostic marker for NSCLC [6]. Serum CEA levels before treatment are usually considered a good prognostic sign, but data on CEA levels in different pathologic cancer types are contradictory [1,[22][23][24]. This was the first study to assess the correlation between serum CEA levels and cryoablation in metastatic NSCLC patients.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical resection with radical lymphadenectomy has been advocated as the treatment of choice for early-stage lung cancer [1]. Primary tumors of the lung are conventionally classified according to their histological appearance into non-small cell lung cancer (NSCLC) and small cell lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Carcinoembryonic antigen as prognostic factor for metastatic non-small cell lung cancer by percutaneous cryosurgery

Tang

Niu

et al. 2013

CBM

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Carcinoembryonic antigen (CEA) is a prognostic marker for early-stage non-small cell lung cancer (NSCLC), and cryoablation is a new therapeutic alternative for lung cancer. We determined whether cryoablation-induced changes in serum CEA levels correlated with tumor type (adenocarcinoma or squamous carcinoma) and treatment type (comprehensive therapy [cryoablation of all intra- and extrapulmonary tumors] or palliative therapy [cryoablation of only extrapulmonary tumors]) in patients with metastatic NSCLC, and assessed whether pre-treatment CEA levels predicted overall survival (OS). We retrospectively reviewed the clinical data of 88 patients with metastatic NSCLC who underwent comprehensive (62 patients) or palliative (26 patients) therapy. Pre- and post-cryoablation serum CEA levels and overall survival were determined for all patients. Cryoablation significantly reduced CEA levels in adenocarcinoma, but not squamous carcinoma, patients. Among adenocarcinoma patients, the cryoablation-induced reduction in CEA levels was significantly greater after comprehensive treatment than after palliative treatment; the OS of patients under comprehensive cryoablation was longer than those under palliative treatment. Among adenocarcinoma patients receiving comprehensive cryoablation, OS was significantly longer in those with normal pre-treatment serum CEA levels than in those with abnormal pre-treatment serum CEA levels. Pretreatment level and change of serum CEA can be a good indicator for therapeutic effects and OS in metastatic NSCLC patients under percutaneous cryosurgery.

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Persistently High Serum Carcinoembryonic Antigen Levels after Surgery Indicate Poor Prognosis in Patients with Stage I Non-Small-Cell Lung Cancer

Cited by 25 publications

References 25 publications

Preoperative serum carcinoembryonic antigen levels are associated with histologic subtype, EGFR mutations, and ALK fusion in patients with completely resected lung adenocarcinoma

Preoperative serum carcinoembryonic antigen levels are associated with histologic subtype, EGFR mutations, and ALK fusion in patients with completely resected lung adenocarcinoma

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

Carcinoembryonic antigen as prognostic factor for metastatic non-small cell lung cancer by percutaneous cryosurgery

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