Prognostic significance of postoperative serum carcinoembryonic antigen levels in patients with completely resected pathological-stage I non-small cell lung cancer.
Prognostic significance of postoperative serum carcinoembryonic antigen levels in patients with completely resected pathological-stage I non-small cell lung cancer.
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DOI：
10.1186/1749-8090-8-106
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发表时间：
2013-04-22
影响因子：
1.6
通讯作者：
Nakajima T
中科院分区：
文献类型：
--
作者：
Kozu Y;Maniwa T;Takahashi S;Isaka M;Ohde Y;Nakajima T
到目前为止，没有明确的建议，定期围手术期测量血清CEA水平的肺癌在任何指南。本研究的目的是评估围手术期血清癌胚抗原（CEA）水平在病理I期非小细胞肺癌（NSCLC）患者的预后意义。我们回顾性分析了263例完全切除的病理I期NSCLC患者的术前和术后血清CEA水平。根据围手术期CEA水平的变化将患者分为：CEA持续正常组（NN组）、CEA持续高水平组（HH组）和术前CEA高水平术后恢复正常组（HN组）。比较3组患者的临床病理因素及总生存期（OS）。对临床病理因素与OS的相关性进行单因素和多因素分析。高术前CEA水平与年龄>70岁、有吸烟史、血清CYFRA 21-1水平高、肿瘤直径较大、存在内脏胸膜浸润（VPI）和中至差分化的男性显著相关。NN和HH组的5年OS率分别为95.5%和59.3%。HN组的4年OS率为85.5%。多因素分析显示肿瘤直径大于30 mm、VPI的存在和HH组是独立的不利预后因素。术后高CEA水平是病理I期NSCLC患者的独立不良预后因素。术后CEA水平高的患者可能受益于辅助化疗。
Until date, there are no clear recommendations for regular perioperative measurements of serum CEA levels for lung cancer in any guidelines. The purpose in the present study is to evaluate the prognostic significance of perioperative serum carcinoembryonic antigen (CEA) levels in patients with pathological-stage I non-small cell lung cancer (NSCLC). We retrospectively reviewed 263 completely resected pathological-stage I NSCLC patients whose preoperative and postoperative serum CEA levels were measured. Patients were subdivided according to the perioperative change of CEA levels: continuously normal CEA levels (NN group), continuously high CEA levels (HH group), and high preoperative CEA levels that returned to normal levels post-operation (HN group). The clinicopathological factors and overall survival (OS) among these 3 groups were compared. Univariate and multivariate analyses of the correlation between clinicopathological factors and OS were performed. High preoperative CEA levels significantly correlated with men aged >70 years with smoking history, high serum CYFRA 21–1 levels, greater tumor diameter, presence of visceral pleural invasion (VPI), and moderate-to-poor differentiation. Five-year OS rates in the NN and HH groups were 95.5% and 59.3%, respectively. Four-year OS rate in the HN group was 85.5%. Multivariate analyses indicated tumor diameter of more than 30 mm, presence of VPI, and the HH group were independent unfavorable prognostic factors. A high postoperative CEA level was an independent unfavorable prognostic factor in pathological-stage I NSCLC patients. Patients with high postoperative CEA levels may benefit from adjuvant chemotherapy.
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影响因子：
4.6
作者：
Buccheri, G;Ferrigno, D
通讯作者：
Ferrigno, D
影响因子：
4.6
作者：
Sawabata, N;Ohta, M;Maeda, H
通讯作者：
Maeda, H
影响因子：
2.6
作者：
Kosugi, S;Nishimaki, T;Hatakeyama, K
通讯作者：
Hatakeyama, K
DOI：
10.1016/j.jtcvs.2005.12.035
发表时间：
2006-05-01
影响因子：
6
作者：
Inoue, M;Minami, M;Okumura, M
通讯作者：
Okumura, M
影响因子：
20.4
作者：
Goldstraw, Peter;Crowley, John;Sobin, Leslie
通讯作者：
Sobin, Leslie