Postoperative Serum CEA Level is a More Significant Prognostic Factor than Post/Preoperative Serum CEA Ratio in Non-small Cell Cancer Patients

Abstract

Background: In non-small cell lung cancer (NSCLC) patients with preoperative high serum carcinoembryonic antigen (CEA) level, patients with a persistently high serum CEA level after surgery have been reported to have a poor prognosis. In addition, in other cancers, the post/preoperative serum CEA ratio has been reported as a useful parameter. Materials and Methods: We enrolled 123 NSCLC patients with preoperative high CEA levels (≥5 ng/mL) who underwent curative surgery between 2004 and 2011. Prognostic significance of postoperative serum CEA level and the CEA ratio was examined. Results: The 5-year survival of patients with persistently high serum CEA level after surgery was poor. On the other hand, patients with normal postoperative serum CEA levels had significant favorable prognosis. The patients with CEA ratio>1 had poor prognosis, however the number was only 7 (5.7%). The 5-year survival rates of patients with other subgroup based on the CEA ratio (0.5≥CEA ratio and 0.5≤CEA ratio≤1) was similar. Multivariate analysis revealed prognostic significance for the postoperative serum CEA level but not the CEA ratio. Conclusions: For NSCLC patients with preoperative high serum CEA level, their postoperative serum CEA levels is a more significant prognostic factor than the post/preoperative serum CEA ratio.

<p>The prognostic value of the postoperative serum CEA levels/preoperative serum CEA levels ratio in colorectal cancer patients with high preoperative serum CEA levels</p>

“…If the surgical removal of the tumor is complete, there is no source of CEA production and the CEA ratio decreases with its metabolic clearance rate. However, if residual tumor cells remain following surgery, the CEA ratio will not normalize 26–28. For normal preoperative CEA patients, the ratio of other tumor markers may be more accurate than the CEA ratio.…”

Dynamics of Serum Tumor Markers Can Serve as a Prognostic Biomarker for Chinese Advanced Non-small Cell Lung Cancer Patients Treated With Immune Checkpoint Inhibitors

“…Serum carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cytokeratin 19 fragment (CYFRA21-1), and squamouscell carcinoma-related antigen (SCC-Ag) might be relevant for the prognosis of patients and have been widely used as biomarkers predicting the efficacy of chemotherapy or targeted therapy in NSCLC patients (20)(21)(22)(23)(24)(25)(26)(27). However, their roles and post-treatment changes from baseline in advanced NSCLC treated by immune checkpoint inhibitors (ICIs) remains unclear.…”

Nomograms for Predicting the Prognostic Value of Pre-Therapeutic CA15-3 and CEA Serum Levels in TNBC Patients

“…The predictive values of serum cancer biomarkers have been documented for several types of cancer, including breast cancer[22,23]. Clinical stages and molecular classification are the two primary factors of current therapeutic decision-making and forecasts of the prognosis of breast cancer.…”