Time course of carcinoembryonic antigen after resection of lung cancer: a predictor of recurrence.
We investigated whether the early postoperative time course of carcinoembryonic antigen (CEA) level after resection of lung cancer could be used to predict patients' prognosis. Fifty-three lung cancer patients were included in this study. Postoperative serum CEA levels were calculated by means of non-linear least-squares fitting to the equation C(t) = (C(0)-C(p))exp(-kt) + C(p), where C(t) is postoperative CEA level, t is days after surgery, C(0) is CEA level at postoperative time 0, C(p) is CEA level at plateau, and k is the rate constant of elimination. Postoperative CEA production (P(p)) was calculated as C(p) multiplied by k. C(p) and P(p) represent the numbers of residual tumor cells after surgery. More residual tumor cells yield higher values of C(p) and P(p), and result in earlier recurrence.


RESULTS
Kinetic parameters could be obtained for 30 patients whose preoperative CEA levels were sufficiently elevated. Cutoff levels as predictors for recurrence were 1.1 ng/ml for C(p) and 0.9 ng/ml/day for P(p). The accuracy of prediction of recurrence using these cutoff levels was 79% with C(p) and 89% with P(p). A very poor prognosis was observed for patients with P(p) over 0.9 ng/ml/day.


CONCLUSIONS
Analysis of the time course of changes in CEA levels after resection of lung cancer appears to be useful for predicting patient prognosis. C(p) and P(p) are very precise predictors of recurrence.
Yoshimasu
Tatsuya
T
Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Kimiidera, Wakayama 641-8509, Japan. yositatu@mail.wakayama-med.ac.jp
Kokawa
Yozo
Y
Oura
Shoji
S
Hirai
Issei
I
Sasaki
Rie
R
Tanino
Hirokazu
H
Sakurai
Teruhisa
T
Okamura
Yoshitaka
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D007700:Kinetics; D008175:Lung Neoplasms / Q000097:blood* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D013997:Time Factors
D015415:Biomarkers; D002272:Carcinoembryonic Antigen