Serum tumor markers level and their predictive values for solid and micropapillary components in lung adenocarcinoma

Abstract

Background: This study aims to reveal the serum tumor marker (STM) levels in lung adenocarcinoma (LUAD) histological subtypes and evaluate their values in predicting the solid and micropapillary components (SMC). Methods:We retrospectively analyzed 3100 invasive LUAD patients between January 2017 and December 2020. Associations between preoperative STMs (CEA, CYFRA21-1, CA199, CA724, NSE, AFP) and LUAD subtypes were evaluated. Multivariate regression analyses were used to determine the independent predictors. Predictive models for SMC were constructed and AUC (area under the curve) was calculated.Results: CEA and CYFRA21-1 levels differed across the LUAD histological subtypes, with the SPA (solid-predominant adenocarcinoma) having the highest level and the LPA (lepidic-predominant adenocarcinoma) harboring the lowest level (p <0.001). Tumors with SMC also had higher CEA and CYFRA21-1 levels than those absence of SMC. Gender, tumor size, CEA, Ki-67, EGFR mutation (solid components only), and tumor differentiation were significantly independently associated with the containing of SMC. Patients were split into two data sets (training set: 2017-2019 and validation set: 2020). The model with gender and tumor size yielded an AUC of 0.723 (training set) and 0.704 (validation set) for the solid component. Combination of CEA, gender, and tumor size led to a significant increase in the predictive accuracy (training set: 0.771, p = 0.009; validation set: 0.747, p = 0.034). The AUC of the model for micropapillary component with only gender and tumor size was 0.699 and 0.711 in the training set and validation set, respectively. Integration of CEA with gender and tumor size significantly improved the predictive performance with an AUC of 0.746 (training set, p = 0.045) and 0.753 (validation set, p <0.001).

A pretreatment prediction model of grade 3 tumors classed by the IASLC grading system in lung adenocarcinoma

“…The predictors in the model included CTR, lobulation, smoking history, and CEA level, and similar results have been shown in previous studies [ 27 – 30 ]. Chen et al defined CTR > 0.5 as radiological invasiveness and used it to construct a radiomics model for predicting micropapillary and solid components, with the sensitivity and specificity reaching 90.00% and 45.21%, respectively [ 27 ].…”

Prognostic value of tumor volume reduction during radiotherapy in patients with locally advanced cervical cancer in different risk groups

“…Therefore, TVR being an important independent prognostic factor in LACC patients, its value in different FIGO stage-groups needed to be veri ed. Serum albumin level, commonly used to assess nutritional status, is also an important prognostic factor for advanced cancer and merits inclusion in prognostic subgroup analyses [18][19][20]. Our ndings not only demonstrate that FIGO stage and pre-treatment albumin are independent prognostic factors in LACC patients, but also con rm that TVR has signi cant prognostic value different subgroups based on the FIGO stage and pre-treatment albumin levels.…”

Evaluation of the preoperative neutrophil-to-lymphocyte ratio as a predictor of the micropapillary component of stage IA lung adenocarcinoma

“…In addition, we have shown that although the CEA concentration and tumor size are independent indicators of the presence of a micropapillary component, their AUCs are low. This may be because of the inclusion of patients in the micropapillary-negative group with a solid component to their tumor, given that there is abundant evidence that the presence of a solid tumor component is often associated with a high CEA concentration 30 and a large tumor. 26 Therefore, in future research, we intend to create more appropriate groups to more accurately evaluate the use of the CEA concentration and tumor size as potential indicators.…”