title: Serum Carcinoembryonic Antigen Levels and the Risk of Whole-body Metastatic Potential in Advanced Non-small Cell Lung Cancer.
abstract: BACKGROUND
  This study aimed to clarify the clinical associations between serum carcinoembryonic antigen (CEA) levels and whole-body metastatic distribution in stage IV NSCLC patients.
  
  
  METHODS
  This study analyzed 377 eligible patients between June 2007 and December 2012. All patients enrolled in the study were newly diagnosed with stage IV NSCLC and had records of pre-treatment serum CEA levels. The serum CEA levels were categorized as normal (< 5 ng/ml) or abnormal (≥ 5 ng/ml) to reveal clinically correlated factors with abnormal serum CEA levels.
  
  
  RESULTS
  The median age of the study cohort was 65 years old (range, 30-94), and 236 (62.6%) patients were male. Two hundred seventy-seven (73.5%) patients had tumors with a histology that is consistent with adenocarcinoma. The median serum CEA value was 8.2 ng/ml (range, 0.1-2872.7), and 218 (57.8%) patients had abnormal serum CEA levels. In multivariate analysis, abnormal serum CEA levels had statistically strong associations with non-squamous cell histology (P=0.002), bone (P=0.001), and brain metastases (P=0.005); and were also closely correlated with positive metastatic LN status (P=0.083) and pulmonary metastasis (P=0.065). Very high serum CEA levels (≥ 100 ng/ml) were additionally correlated with abdominal/pelvic metastasis (P < 0.001).
  
  
  CONCLUSIONS
  Our findings suggested that abnormal serum CEA levels were strongly correlated with increased whole-body metastatic potential in advanced NSCLC. The results provided evidence for future exploratory anti-CEA targeting and intensive systemic assessment in advanced NSCLC patients with abnormal serum CEA levels.
authors.affiliation: 1. Department of Radiation Oncology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, South Korea; ; 6. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Lee
authors.affiliation: 2. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: 3. Department of Medical Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kang
authors.affiliation: 3. Department of Medical Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;
authors.forename: Sook Hee
authors.initials: SH
authors.lastname: Hong
authors.affiliation: 3. Department of Medical Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;
authors.forename: Eun Kyoung
authors.initials: EK
authors.lastname: Jeon
authors.affiliation: 2. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;
authors.forename: Young Kyoon
authors.initials: YK
authors.lastname: Kim
authors.affiliation: 4. Department of Nuclear Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;
authors.forename: Ie Ryoung
authors.initials: IeR
authors.lastname: Yoo
authors.affiliation: 5. Department of Thoracic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;
authors.forename: Jae Gil
authors.initials: JG
authors.lastname: Park
authors.affiliation: 6. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Jang
authors.affiliation: 6. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Hyo Chun
authors.initials: HC
authors.lastname: Lee
authors.affiliation: 6. Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Yeon Sil
authors.initials: YS
authors.lastname: Kim
keywords: Carcinoembryonic antigen; Immunotherapy; Metastases; Non-small cell lung cancer; Tumor marker.