The prognostic value of serum CA 19-9 for patients with advanced lung adenocarcinoma

Abstract

BackgroundThis study aimed to assess the prognostic accuracy of serum CA 19-9 in patients with advanced lung adenocarcinoma.MethodsWe retrospectively reviewed data of 246 patients who were diagnosed at our institute with advanced (stage IIIB or IV) lung adenocarcinoma between March 2006 and December 2012. We excluded patients who received no chemotherapy, or for whom we had no data on pre-treatment tumor markers. We also evaluated 116 consecutive resected specimens from patients with clinical stage I lung adenocarcinoma pathologically.ResultsThe 76 (31 %) patients who were CA 19-9+ had shorter overall survival (OS) than CA 19-9− group (12.5 vs 26.2 months, P = 0.005). Cox’s multivariate regression analysis identified Eastern Cooperative Oncology Group Performance Status 0 or 1 (P < 0.001), mutated epidermal growth factor receptor (EGFR) status (P < 0.001), stage IIIB (P < 0.001), CYFRA 21-1− (P < 0.001), CA 19-9− (P = 0.005) and use of platinum doublet therapy (P = 0.034) as independent predictors of longer OS. We stratified patients by CA 19-9 and CYFRA 21-1 as double positive (CA 19-9+/CYFRA 21-1+, n = 59), single positive (either CA19-9+ or CYFRA 21-1+, n = 113), or double negative (CA 19-9−/CYFRA 21-1−, n = 74). Their respective OS were 10.0, 23.3 and 31.8 months (P < 0.001). Pathological analysis also correlated CA 19-9 expression with malignant features such as vessel invasion, pleural invasion, cancer invasive factors and mucin production.ConclusionsCA 19-9 and CYFRA 21-1 are independent prognostic markers in patients with advanced lung adenocarcinoma. Combined use of CA 19-9 and CYFRA 21-1 provides further prognostic information in patients with advanced lung adenocarcinoma.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2897-6) contains supplementary material, which is available to authorized users.

Correlation between serum carbohydrate antigen 19-9 levels and computed tomography severity score in patients with nontuberculous mycobacterial pulmonary disease

“…We excluded patients with comorbidities that could independently cause elevated serum CA19-9 levels from 1823 patients with NTM-PD. These comorbidities included stomach cancer 16 , colon cancer 17 , pancreatobiliary cancer 18 , 19 , lung cancer 20 , thyroid cancer 21 , benign hepatobiliary diseases 22 , 23 , thyroiditis 24 , and ovarian cysts 25 , 26 . The inclusion criteria were as follows: patients who underwent assessments for serum CA19-9 levels and chest CT scanning with an interval of less than 30 days between the two examinations and participants who underwent serum CA19-9 assessment in the time period between 1 month before the diagnosis and the initiation of NTM-PD treatment, which was considered as the active disease period of NTM-PD.…”

Carbohydrate antigen 19-9 — tumor marker: Past, present, and future

“…Malignant pulmonary diseases: Amongst lung cancer subtypes, CA 19-9 has potential in diagnosis, staging, prognostication, and prediction for complications and recurrences of Non-Small Cell Lung Cancer (NSCLC) specifically. However, a caveat is that only a minority of NSCLC patients express elevated CA 19-9 levels[ 107 , 108 ].…”

“…The prognostic role of CA 19-9 is controversial. A study by Sato et al [ 108 ] involving 246 Stage IIIB and Stage IV lung adenocarcinoma patients demonstrated that serum CA 19-9 was an independent prognostic marker in lung adenocarcinoma[ 108 ]. In contrast, another study by Tsoukalas et al [ 107 ] involving 100 NSCLC patients, who were not stratified by stage, showed that elevated CA 19-9 levels correlated with shorter OS, but could not prove CA 19-9 to be an independent prognostic factor[ 107 ].…”

“…In contrast, another study by Tsoukalas et al [ 107 ] involving 100 NSCLC patients, who were not stratified by stage, showed that elevated CA 19-9 levels correlated with shorter OS, but could not prove CA 19-9 to be an independent prognostic factor[ 107 ]. Sato et al [ 108 ] also reported that stronger immunohistochemistry staining for CA 19-9 correlated with shorter RFS in 116 clinical stage I lung adenocarcinoma patients[ 108 ]. However, Ma et al [ 111 ]’ s study involving 164 patients showed that CA 19-9 had limited prognostic value in Stage 1 NSCLC[ 111 ].…”

Conflicting immunohistochemistry and metabolic imaging parameters in adenocarcinoma lung showing elevated serum CA 19-9 with immunonegative TTF1 and Napsin A

“…Carbohydrate antigen 19-9 (CA 19-9) is isolated from a human colorectal cancer cell line. 7,9 Although applied in the diagnosis of pancreatico-biliary adenocarcinoma, it can be positive in advanced lung adenocarcinoma (ALADC) also. 10 CA 19-9 is extremely elevated in advanced lung adenocarcinoma.…”