Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis.
Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis.
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晚期非小细胞肺癌中与癌胚抗原（CEA）水平相关的脑转移发展和不良生存：一项前瞻性分析。
DOI：
10.1186/1471-2407-9-119
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发表时间：
2009-04-22
期刊：
影响因子：
3.8
通讯作者：
De la Garza J
中科院分区：
文献类型：
--
作者：
Arrieta O;Saavedra-Perez D;Kuri R;Aviles-Salas A;Martinez L;Mendoza-Posada D;Castillo P;Astorga A;Guzman E;De la Garza J
中枢神经系统是非小细胞肺癌常见的转移部位，预后差，生活质量差。本前瞻性研究的目的是评估临床病理因素（CPF）、血清CEA水平、EGFR和HER 2组织表达在晚期NSCLC患者脑转移（BM）和总生存期（OS）中的预后意义。我们以前瞻性方式研究了293例IIIB-IV期NSCLC患者。他们接受了标准化疗。治疗前测量CEA;通过免疫组织化学评估EGFR和HER 2。在有症状的患者中，通过MRI证实了BM的发展。诊断为腺癌（RR 5.2; 95% CI，1.002-29; p = 0.05）和CEA ≥ 40 ng/mL（RR 11.4; 95% CI，1.7-74; p < 0.01）的患者在1年和2年时分别有27例和32%发生BM。EGFR和HER 2无统计学意义。阳性（RR 1.4; 95% CI，1.002-1.9; p = 0.048），体能状态差（RR 1.8; 95% CI，1.5-2.3; p = 0.002），晚期临床分期（RR 1.44; 95% CI，1.02-2; p = 0.04），CEA ≥ 40 ng/mL（RR 1.5; 95% CI，1.09-2.2; p = 0.014）和EGFR表达（RR 1.6; 95% CI，1.4-1.9; p = 0.012）是恶化OS的独立相关因素。高CEA血清水平是BM发展的危险因素，与晚期NSCLC患者的不良预后相关。肿瘤细胞表面CEA的表达可能是肿瘤侵袭中枢神经系统的病理生理机制。
Central nervous system is a common site of metastasis in NSCLC and confers worse prognosis and quality of life. The aim of this prospective study was to evaluate the prognostic significance of clinical-pathological factors (CPF), serum CEA levels, and EGFR and HER2 tissue-expression in brain metastasis (BM) and overall survival (OS) in patients with advanced NSCLC. In a prospective manner, we studied 293 patients with NSCLC in IIIB-IV clinical stage. They received standard chemotherapy. CEA was measured prior to treatment; EGFR and HER2 were evaluated by immunohistochemistry. BM development was confirmed by MRI in symptomatic patients. BM developed in 27, and 32% of patients at 1 and 2 years of diagnosis with adenocarcinoma (RR 5.2; 95% CI, 1.002–29; p = 0.05) and CEA ≥ 40 ng/mL (RR 11.4; 95% CI, 1.7–74; p < 0.01) as independent associated factors. EGFR and HER2 were not statistically significant. Masculine gender (RR 1.4; 95% CI, 1.002–1.9; p = 0.048), poor performance status (RR 1.8; 95% CI, 1.5–2.3; p = 0.002), advanced clinical stage (RR 1.44; 95% CI, 1.02–2; p = 0.04), CEA ≥ 40 ng/mL (RR 1.5; 95% CI, 1.09–2.2; p = 0.014) and EGFR expression (RR 1.6; 95% CI, 1.4–1.9; p = 0.012) were independent associated factors to worse OS. High CEA serum level is a risk factor for BM development and is associated with poor prognosis in patients with advanced NSCLC. Surface expression of CEA in tumor cells could be the physiopathological mechanism for invasion to CNS.
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DOI：
10.1016/s0360-3016(96)00619-0
发表时间：
1997-03-01
影响因子：
7
作者：
Gaspar, L;Scott, C;Byhardt, R
通讯作者：
Byhardt, R
影响因子：
3.1
作者：
Moore, R;Doherty, D;Khuri, F
通讯作者：
Khuri, F
DOI：
10.1016/s0360-3016(98)00213-2
发表时间：
1998-09-01
影响因子：
7
作者：
Komaki, R;Scott, CB;Gaspar, LE
通讯作者：
Gaspar, LE
影响因子：
11.2
作者：
Blumenthal, RD;Hansen, HJ;Goldenberg, DM
通讯作者：
Goldenberg, DM
影响因子：
6.2
作者：
CONCANNON, JP;DALBOW, MH;LIEBLER, GA
通讯作者：
LIEBLER, GA