title: Clinical significance of preoperative carcinoembryonic antigen level for clinical stage I non-small cell lung cancer: can preoperative carcinoembryonic antigen level predict pathological stage?
abstract: The purpose of the present study was to retrospectively analyze the clinicopathological characteristics and clarify whether or not the preoperative carcinoembryonic antigen (CEA) level could be used as a decision-making factor as an adjunct to the TNM staging system in patients with clinical stage I non-small cell lung cancer (NSCLC). Between 1993 and 2006, 815 patients who had clinical stage I NSCLC were analyzed retrospectively. The CEA level was defined as being either normal (CEA<or=5 ng/ml), high (5<CEA<or=30 ng/ml) and very high (CEA>30 ng/ml) sub-groups. The rate of patients with an elevated CEA level was 33.6%. The five-year disease-free survival rates for patients with normal, high and very high CEA levels were 76.7, 60.0 and 31.3%, respectively. The survival curve for patients with a normal CEA level almost overlapped that for p-stage I, that for a high CEA level nearly overlapped that for p-stage II, and that for a very high CEA level nearly overlapped that for p-stage III. The present study demonstrated that the preoperative CEA level was a very good predictor of the pathological stage. These findings suggest that the preoperative CEA level may be useful as an adjunct to the TNM staging system.
authors.affiliation: Thoracic Surgery Division, Kyorin University Hospital, Mitaka-shi, Tokyo 181-0004, Japan. rkawachi@kpe.biglobe.ne.jp
authors.forename: Riken
authors.initials: R
authors.lastname: Kawachi
authors.forename: Yohko
authors.initials: Y
authors.lastname: Nakazato
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Takei
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Koshi-ishi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Goya
mesh_terms: D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011300:Preoperative Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D002272:Carcinoembryonic Antigen