Usefulness of serum carcinoembryonic antigen (CEA) in evaluating response to chemotherapy in patients with advanced non small-cell lung cancer: a prospective cohort study.
Usefulness of serum carcinoembryonic antigen (CEA) in evaluating response to chemotherapy in patients with advanced non small-cell lung cancer: a prospective cohort study.
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DOI：
10.1186/1471-2407-13-254
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发表时间：
2013-05-22
期刊：
影响因子：
3.8
通讯作者：
Alatorre-Alexander J
中科院分区：
文献类型：
--
作者：
Arrieta O;Villarreal-Garza C;Martínez-Barrera L;Morales M;Dorantes-Gallareta Y;Peña-Curiel O;Contreras-Reyes S;Macedo-Pérez EO;Alatorre-Alexander J
高血清癌胚抗原（CEA）水平是非小细胞肺癌（NSCLC）患者复发和生存的独立预后因素。其作为治疗反应的预测标志物的作用尚未得到广泛表征。纳入了180例基线时CEA血清水平升高（>10 ng/ml）且既往化疗方案不超过1种的晚期NSCLC（IIIB期或IV期）患者。在两个周期的铂类化疗（93%）或酪氨酸激酶抑制剂（7%）治疗后测量CEA水平。我们评估了血清CEA水平的变化以及与RECIST标准测量的反应的相关性。两个化疗周期后，达到客观缓解的患者（OR，28.3%）CEA水平下降55.6%（95% CI 64.3-46.8），ROC曲线下面积（AURC）为0.945（95% CI 0.91-0.99），CEA降低≥ 14%的敏感性和特异性分别为90.2%和89.9%。CEA水平降低≥14%的患者总体缓解率为78%，疾病稳定率为20.3%，进展率为1.7%，而未降低≥14%的患者总体缓解率为4.1%，疾病稳定率为63.6%，进展率为32.2%（p < 0.001）。稳定（49.4%）和进展性疾病（22.2%）患者的CEA水平较基线分别增加9.4%（95%CI 1.5-17.3）和87.5%（95%CI 60.9-114）（p < 0.001）。进展性疾病的AURC为0.911（95% CI 0.86-0.961），CEA升高≥ 18%时的敏感性和特异性分别为85%和15%。CEA降低≥14%的患者PFS较长（8.7个月vs. 5.1个月，p < 0.001）。CEA水平的降低并不能预测OS。CEA水平的降低是OR的敏感和特异性标志物，也是基线时CEA升高且接受不超过一种化疗方案的晚期NSCLC患者进展至化疗的敏感指标。CEA水平降低14%与PFS延长相关。
High serum carcinoembryonic antigen (CEA) levels are an independent prognostic factor for recurrence and survival in patients with non-small cell lung cancer (NSCLC). Its role as a predictive marker of treatment response has not been widely characterized. 180 patients with advanced NSCLC (stage IIIB or Stage IV), who had an elevated CEA serum level (>10 ng/ml) at baseline and who had no more than one previous chemotherapy regimen, were included. CEA levels were measured after two treatment cycles of platinum based chemotherapy (93%) or a tyrosine kinase inhibitor (7%). We assessed the change in serum CEA levels and the association with response measured by RECIST criteria. After two chemotherapy cycles, the patients who achieved an objective response (OR, 28.3%) had a reduction of CEA levels of 55.6% (95% CI 64.3-46.8) compared to its basal level, with an area under the ROC curve (AURC) of 0.945 (95% CI 0.91-0.99), and a sensitivity and specificity of 90.2 and 89.9%, respectively, for a CEA reduction of ≥14%. Patients that achieved a decrease in CEA levels ≥14% presented an overall response in 78% of cases, stable disease in 20.3% and progression in 1.7%, while patients that did not attain a reduction ≥14% had an overall response of 4.1%, stable disease of 63.6% and progression of 32.2% (p < 0.001). Patients with stable (49.4%) and progressive disease (22.2%) had an increase of CEA levels of 9.4% (95% CI 1.5-17.3) and 87.5% (95% CI 60.9-114) from baseline, respectively (p < 0.001). The AURC for progressive disease was 0.911 (95% CI 0.86-0.961), with sensitivity and specificity of 85 and 15%, respectively, for a CEA increase of ≥18%. PFS was longer in patients with a ≥14% reduction in CEA (8.7 vs. 5.1 months, p < 0.001). Reduction of CEA was not predictive of OS. A CEA level reduction is a sensitive and specific marker of OR, as well as a sensitive indicator for progression to chemotherapy in patients with advanced NSCLC who had an elevated CEA at baseline and had received no more than one chemotherapy regimen. A 14% decrease in CEA levels is associated with a longer PFS.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
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。
影响因子：
3.8
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
通讯作者：
De la Garza J
影响因子：
4.6
作者：
Sawabata, N;Ohta, M;Maeda, H
通讯作者：
Maeda, H
影响因子：
45.3
作者：
Desch, CE;Benson, A;Petrelli, NJ
通讯作者：
Petrelli, NJ
影响因子：
45.3
作者：
Iwanicki-Caron, Isabelle;Di Fiore, Frederic;Michel, Pierre
通讯作者：
Michel, Pierre