Prognostic value of baseline carcinoembryonic antigen and cytokeratin 19 fragment levels in advanced non-small cell lung cancer

Article type: Research Article

Authors: Baek, Ae Rin^{a; 1} | Seo, Hyun Jung^{a; 1} | Lee, June Hyuk^a | Park, Sung Woo^a | Jang, An Soo^a | Paik, Sang Hyun^b | Koh, Eun Suk^c | Shin, Hwa Kyun^d | Kim, Do Jin^{a; *}

Affiliations: [a] Division of Respiratory and Allergy, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Wonmi-gu, Bucheon-si, Gyeonggi-do, Korea | [b] Department of Organ transplantation center, Vinmec Hospital, Vietnam | [c] Department of Clinical Pathology, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Wonmi-gu, Bucheon-si, Gyeonggi-do, Korea | [d] Department of Thoracic Surgery, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Wonmi-gu, Bucheon-si, Gyeonggi-do, Korea

Correspondence: [*] Corresponding author: Do Jin Kim, Division of Respiratory and Allergy, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, 1174, Jung-dong, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14584, Korea. Tel.: +82 32 621 5144; Fax: +82 32 621 5016; Mobile: +82 10 4527 1754; E-mail: kdj@schmc.ac.kr.

Note: [1] Contributed equally to this work.

Abstract: BACKGROUND: Serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21-1) levels are prognostic predictors in non-small cell lung cancer (NSCLC). However, even in patients with the same stage of cancer, the serum levels of those markers often vary. OBJECTIVE: We investigated the association between the initial biomarker levels and prognosis. METHODS: We retrospectively reviewed 445 patients with advanced NSCLC and their baseline serum CEA and CYFRA 21-1 levels. Patients were divided into four groups according to the initial levels of those markers: the NN, HN, NH, and HH group. Kaplan-Meier survival analysis with Log-rank test and Cox proportional hazards regression analysis were performed. RESULTS: The 5-year overall survival (OS) rate in the HN group was the highest (32.2%). Multivariate analyses indicated that the HN group (HR 0.520, 95% CI 0.309–0.878, P= 0.014), female sex (HR 0.685, 95% CI 0.498–0.944, P= 0.021), serum CRP level (HR 1.057, 95% CI 1.034–1.080, P< 0.001), chemotherapy (HR 0.324, 95% CI 0.228–0.460, P< 0.001), and chemotherapy/radiotherapy (HR 0.266, 95% CI 0.171–0.414, P< 0.001) were independent prognostic factors for overall survival. CONCLUSIONS: In advanced NSCLC, patients with baseline high serum CEA but low CYFRA 21-1 level have a significant longer overall survival regardless of clinical stage.

Keywords: CEA, CYFRA 21-1, tumor marker, prognostic factor, NSCLC

DOI: 10.3233/CBM-170885

Journal: Cancer Biomarkers, vol. 22, no. 1, pp. 55-62, 2018