Increased serum carcinoembryonic antigen level can predict poor survival of patients with small cell lung cancer.
Increased serum tumor biomarkers are usually associated with huge tumor burden, but the prognostic value of these markers remains controversial. The serum levels of carcinoembryonic antigen (CEA), nerve cell-specific enolase, and lactate dehydrogenase in 281 patients with small cell lung cancer (SCLC) were analyzed in this study. Increased serum CEA levels were observed in 92 (32.7%) patients. Survival was superior in patients with normal serum CEA levels compared with those with increased serum CEA levels. The median survival time, 2-year overall survival (OS) rate, and 3-year OS rate were 19.1 months vs 14.6 months, 42.7% vs 28.3%, and 30.6% vs 14.1%, respectively (P = 0.002). In multivariate analysis, extensive-stage (ES)-SCLC (hazard ratio [HR] = 1.936, P = 0.001), an increased serum CEA level (HR = 1.432, P = 0.021) at diagnosis, and <4 cycles of chemotherapy (ChT) (HR = 0.432, P = 0.001) were independent negative prognostic factors for the OS. Additionally, normal CEA level (HR = 1.678, P = 0.012), treatment modalities including surgery (HR = 1.595, P = 0.049), and ≥ 4 cycles of ChT (HR = 1.880, P = 0.004) were independent positive prognostic factors for OS in patients with local disease. In the subgroup with ES-SCLC, normal serum CEA level (HR = 1.608, P = 0.043), thoracic radiation therapy (HR = 1.744, P = 0.005), and ≥ 4 cycles of ChT (HR = 2.626, P = 0.001) were independent positive prognostic factors for OS.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China.
Hui
H
Zhu
Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China.
Hongbo
H
Guo
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China.
Minghuan
M
Li
Department of Medical Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China.
Yan
Y
Zhang
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China.
Anqin
A
Han
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China.
Fang
F
Shi
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China. Electronic address: kongli7@sina.com.
Li
L
Kong
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China. Electronic address: sdyujinming@126.com.
Jinming
J
Yu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D055752:Small Cell Lung Carcinoma / Q000097:blood*; D016019:Survival Analysis; D016896:Treatment Outcome
D002272:Carcinoembryonic Antigen