Prediction of survival and recurrence by serum and cytosolic levels of CEA, CA125 and SCC antigens in resectable non-small-cell lung cancer

Abstract

Summary Risk of death and risk of recurrence in 108 potentially curable non-small-cell lung cancer patients were analysed with respect to TNM stage, histological type and carcinoembryonic antigen (CEA), CA125 antigen and squamous cell carcinoma antigen (SCC) levels in serum and cytosol. CA125 and CEA levels were closely related to outcome figures. Multivariate analyses indicated that TNM stage and histological type had the best predictive power, but serum and cytosolic CA125 and serum CEA contained additional, independent prognostic information. Predictive information drawn from serum and cytosolic levels proved mutually complementary. We conclude that CA125 and CEA complement TNM classification and histological type for the purpose of quantifying risk of death or recurrence.Keywords: carcinoembryonic antigen; CA125; squamous cell carcinoma antigen; lung cancer; prognostic factor; survivalThe tumour -node-metastasis (TNM) classification system is the cornerstone for planning therapy options in patients with non-small-cell lung cancer (NSCLC) (Bains, 1991). Such staging of tumour spread is the best available prognostic factor. However, its predictive power is limited. Differences may be seen between expected and actual outcome after curative resection among patients within the same TNM category of risk. Efforts are under way to confirm the possibility that long-term results or response to treatment may be partially based on biological characteristics inherent in tumour cells (Carney, 1991). Methods for the description of biological tumour aggressiveness are rapidly expanding (Carney, 1991;Lee and Hong, 1992).Owing to their low sensitivity and specificity, tumour markers have, until now, played a less important role in the diagnosis and management of NSCLC than has been the case with most other common cancers (Bergman et al., 1993;Strauss and Skarin, 1994;Jarvisalo et al., 1993 (Gail et al., 1984;Sanchez et al., 1994), guiding follow-up after surgical treatment (Diez et al., 1995) and monitoring response to chemotherapy in advanced disease (Shinkai et al., 1986;Spiridonis et al., 1995). CA125 was initially described as an ovarian cancer-associated antigen, and has recently been assayed in NSCLC. In a previous study we reported that serum levels of CA 125 provide independent information on survival and tumour relapse in patients undergoing curative surgical treatment for NSCLC (Diez et al., 1994a Analysis of tumour marker expression in NSCLC tumour tissue has not been reported as frequently. In a previous study we observed that cytosolic concentration of CEA, SCC and CA125 is a particular and distinctive characteristic of each histological type, something which could aid pathological classification (Picardo et al., 1994). In addition, high CEA plus high CA125 content allows for identification of the large-cell carcinoma histological subtype (Picardo et al., 1994). In our opinion, this kind of study could lead to a better understanding of the relationship between tumour marker and the biological features of the neop...

Clinical value of p53, c‐erbB‐2, CEA and CA125 regarding relapse, metastasis and death in resectable non‐small cell lung cancer

“…CA125 was not related with a specific type of metastasis, as no differences were found when pre-surgical levels in patients who developed brain, liver and bone metastasis were compared (data not shown). The low serum CA125 concentration in our cohort in comparison with other series 12,47,53,56 pushed us to use a lower cut-off. Even among patients who developed metastasis, Ͻ25% showed levels higher than 15 U/ml.…”

“…Cutoffs for both markers, specified in advance based on previous studies, were 5 ng/ml for CEA and 15 U/ml for CA 125. 12,13 …”

Low expression of polypeptide GalNAc N-acetylgalactosaminyl transferase-3 in lung adenocarcinoma: impact on poor prognosis and early recurrence

“…In the past few years, O-linked carbohydrate antigens, such as mucin antigen (MUC1), carcinoembryonic antigen (CEA), sialyl LewisX (SLX), CA19-9, Sialyl Tn (STn), and Tn have been reported to be associated with altered adhesion (Fogel et al, 1983;Rice and Bevilacqua, 1989), invasion (Bolscher et al, 1988;Matsushita et al, 1991;Nakamori et al, 1994), recurrence, and prognosis (Itzkowitz et al, 1990;Niklinski et al, 1992;Ogawa et al, 1994;Cao et al, 1995;Diez et al, 1996;Ohgami et al, 1999) in lung cancer and other tumours. Mucin-type O-linked carbohydrates may constitute up to 80% of the total mass of these glycoproteins ; O-glycosylation has been shown to be important in the binding of cell adhesion molecules, cell differentiation, invasion, and metastasis in tumours (Nakamori et al, 1994;Clausen and Bennett, 1996;Sutherlin et al, 1997;Nomoto et al, 1999).…”

Lung tumour markers in oncology practice: a study of TPA and CA125

“…Using appropriate thresholds, surgical resectability (Buccheri andFerrigno, 1995b, 2001b) and objective responses to treatment (Buccheri and Ferrigno, 1995a) could be predicted with an accuracy similar to that of computed tomography. Evidence concerning the clinical value of CA125 is also remarkable and, again, it is mainly due to one group of investigators (Diez et al, 1991(Diez et al, , 1996Picardo et al, 1994). Like TPA, the concentration of CA125 in the sera or in tumour cell cytosols of lung cancer patients has been found increased in the most advanced stages of disease (Diez et al, 1991;Kimura et al, 1990;Picardo et al, 1994) and prognostically significant (Diez et al, , 1996.…”