title: Preoperative serum carcinoembryonic antigen level is a prognostic factor in women with early non-small-cell lung cancer.
abstract: BACKGROUND
  Carcinoembryonic antigen (CEA) is one of the markers evaluated in patients with non-small cell lung cancer (NSCLC). The significance of the preoperative serum CEA level in female patients with NSCLC is seldom discussed. In this study, we conducted a retrospective review to investigate the prognostic significance of the preoperative CEA level in female patients with stage I NSCLC.
  
  
  METHODS
  In this study, we looked at 163 female patients with stage I NSCLC. Patient charts were reviewed to collect patient data, including the age of the patient, tumor location, tumor size, visceral pleural invasion, the stage of disease, and the preoperative serum CEA level. The cutoff value of serum CEA level was 6.0 ng/mL. The significance of preoperative CEA level in the prognosis of female patients with stage I NSCLC was evaluated.
  
  
  RESULTS
  Among the 163 female patients with stage I NSCLC, 47 patients (28.8%) had abnormal preoperative serum CEA level (>6 ng/mL). Diagnosis of adenocarcinoma and bronchoalveolar carcinoma accounted for 83.4% of these 163 female patients. In-hospital mortality was encountered in 1 patient. Univariate analysis of survival in the other 162 female patients with stage I NSCLC showed that age, stage, tumor size, and preoperative CEA level were prognostic factors. Visceral pleural invasion had no impact on the prognosis of these patients. Multivariate analysis revealed that tumor size and preoperative CEA level were independent prognostic factors in female patients with stage I NSCLC.
  
  
  CONCLUSIONS
  Preoperative serum CEA level and tumor size are independent prognostic factors in female patients with stage I NSCLC. In contrast, visceral pleural invasion was not associated with the prognosis. Importantly, these results suggest that female patients with abnormally high preoperative CEA level and tumor size larger than 3 cm may need a thorough preoperative evaluation and careful postoperative follow-up to rule out occult metastasis of early NSCLC.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan. whhsu@vghtpe.gov.tw
authors.forename: Wen-Hu
authors.initials: WH
authors.lastname: Hsu
authors.forename: Chien-Sheng
authors.initials: CS
authors.lastname: Huang
authors.forename: Han-Shui
authors.initials: HS
authors.lastname: Hsu
authors.forename: Wen-Jen
authors.initials: WJ
authors.lastname: Huang
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Lee
authors.forename: Biing-Shiun
authors.initials: BS
authors.lastname: Huang
authors.forename: Min-Hsiung
authors.initials: MH
authors.lastname: Huang
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000601:surgery; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000097:blood / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010994:Pleura / Q000473:pathology; D011300:Preoperative Care; D011379:Prognosis; D013510:Pulmonary Surgical Procedures; D012189:Retrospective Studies
chemical_list: D002272:Carcinoembryonic Antigen