Predictive value of perioperative carcinoembryonic antigen changes for recurrence in non-small cell lung cancer.

IF 4 2区 医学 Q2 ONCOLOGY
Translational lung cancer research Pub Date : 2025-02-28 Epub Date: 2025-02-23 DOI:10.21037/tlcr-24-776
Hua Sun, Sikai Wu, Zhongxiao Chen, Hao Liu, William C Cho, Pasan Witharana, Minhua Ye, Dehua Ma, Chunguo Wang, Chengchu Zhu, Jianfei Shen
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引用次数: 0

Abstract

Background: Despite surgical resection, the prognosis for patients with non-small cell lung cancer (NSCLC) remains unsatisfactory. The objective of this study was to investigate the impact of serum carcinoembryonic antigen (CEA) levels on recurrence in patients with NSCLC before and after surgical resection. In addition, for patients with invasive lung adenocarcinoma (IAC), which constitutes the majority of cases, we further explored the effect of pathological subtype on recurrence.

Methods: A total of 349 patients were included in the study. The correlation between clinicopathological factors and post-surgery survival outcomes was analyzed. Kaplan-Meier curves were constructed based on the pertinent data and analyzed using the Cox regression model. Recurrence risk curves were plotted according to the time to recurrence for each CEA subgroup and pathological subtype to explore the change in recurrent rate over time in each group.

Results: A total of 9 (81.82%) patients in the low preoperative CEA but higher than normal postoperative CEA levels group experienced recurrence, with a median recurrence-free survival (RFS) of only 24 months and a median overall survival (OS) of 57 months. These outcomes demonstrated poorer RFS and OS than those observed in the other three groups. Multivariate analysis of RFS revealed postoperative CEA level (P<0.001), histological type (P=0.01), tumour size (P=0.048), tumor-node-metastasis (TNM) stage (P<0.001) and pN stage (P=0.04) as independent poor prognostic factors. postoperative CEA level (P=0.003), histological type (P=0.02), tumor size (P=0.03), TNM stage (P=0.004) and pN stage (P=0.049) were independent poor prognostic factors for OS. Among the pathological subtypes, patients with Grade 3 (high-grade patterns ≥20%) exhibited a higher risk of recurrence after surgery.

Conclusions: Elevated CEA levels in the postoperative period, as well as pathological subtypes of Grade 3, have been identified as risk factors for early recurrence in NSCLC patients after surgery.

非小细胞肺癌围手术期癌胚抗原变化对复发的预测价值。
背景:尽管手术切除,非小细胞肺癌(NSCLC)患者的预后仍然令人不满意。本研究的目的是探讨血清癌胚抗原(CEA)水平对非小细胞肺癌手术切除前后复发的影响。此外,对于占多数的侵袭性肺腺癌(IAC)患者,我们进一步探讨了病理亚型对复发的影响。方法:共纳入349例患者。分析临床病理因素与术后生存结局的相关性。根据相关数据构建Kaplan-Meier曲线,采用Cox回归模型进行分析。根据各CEA亚组和病理亚型的复发时间绘制复发风险曲线,探讨各组复发率随时间的变化。结果:术前CEA低但术后CEA高于正常组9例(81.82%)患者复发,中位无复发生存期(RFS)仅为24个月,中位总生存期(OS)为57个月。这些结果表明RFS和OS比其他三组更差。RFS多因素分析显示术后CEA水平(p)。结论:术后CEA水平升高以及病理亚型为3级是NSCLC术后早期复发的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
2.50%
发文量
137
期刊介绍: Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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