Serum carcinoembryonic antigen level in surgically resected clinical stage I patients with non-small cell lung cancer
Serum carcinoembryonic antigen level in surgically resected clinical stage I patients with non-small cell lung cancer
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DOI：
10.1016/s0003-4975(02)03662-7
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发表时间：
2002-07-01
影响因子：
4.6
通讯作者：
Maeda, H
中科院分区：
文献类型：
--
作者：
Sawabata, N;Ohta, M;Maeda, H
背景资料。血清癌胚抗原(CEA)作为临床I期非小细胞肺癌(NSCLC)预后指标的有效性尚无普遍共识。我们进行了一项回顾性研究，以探讨血清CEA水平与生存的关系。我们评估了从1985年到1998年在Toneyama国立医院接受手术切除的297名临床I期非小细胞肺癌患者。采用酶联免疫吸附测定试剂盒检测血清CEA水平，以良性肺部疾病95%的特异度为标准，将正常上限定义为7.0 ng/m L。血清CEA>7.0 ng/m L者56例，占19%。高癌胚抗原组的中位生存期为50个月，5年生存率为49%，而癌胚抗原正常组的5年生存率为72%(p<；0.0001)。术后CEA水平升高的患者(n=15)预后较差(中位生存期35个月，5年生存率18%)，而CEA恢复正常者(n=41，中位生存期8.8个月，5年生存率68%；p=0.01)。这些差异在病理I期或II期肿瘤患者中也观察到，但在病理III期或IV期肿瘤患者中没有观察到。血清CEA水平是临床I期NSCLC患者生存的有用预测指标，术后持续高CEA水平是预后极差的一个特别强烈的指标。(C)2002年，由胸外科医生学会提供。
Background. There is little general agreement concerning the effectiveness of serum carcinoembryonic antigen (CEA) as a prognostic indicator for non-small cell lung cancer (NSCLC) in clinical stage I patients. We conducted a retrospective study to investigate the relationship between serum CEA level and survival.Methods. We assessed 297 consecutive patients with clinical stage I NSCLC who underwent surgical resection at Toneyama National Hospital from 1985 to 1998. Serum CEA levels were measured with an enzyme-linked immunosorbent assay kit with the upper limit of normal defined as 7.0 ng/mL based on the 95% specificity level for benign lung disease, in our hospital.Results. There were 56 (19%) patients with serum CEA greater than 7.0 ng/mL. The high CEA group had a median survival time of 50 months and a 5-year survival rate of 49% compared with a 5-year survival rate of 72% (p < 0.0001) for the normal CEA group (n = 241). Patients with postoperatively high CEA levels (n = 15) had the worse prognosis (median survival time 35 months, and 5-year survival 18%) compared with patients whose levels returned to normal (n = 41, median survival time 8 8 months, and 5-year survival 68%; p = 0.01). These differences were also observed in patients with pathologic stage I or II tumors but not in those with pathologic stage III or IV tumors.Conclusions. Serum CEA level is a useful predictor of survival for patients with-clinical stage I NSCLC, and a persistently high CEA level after surgery is an especially strong indicator of a very poor prognosis. (C) 2002 by The Society of Thoracic Surgeons.