Predictive and prognostic value of preoperative serum tumor markers in resectable adenosqamous lung carcinoma.
BACKGROUND
Adenosquamous carcinoma is a rare and aggressive form of lung cancer. The prognostic and predictive value of preoperative serum tumor markers and frequency of EGFR mutations in adenosquamous lung carcinoma are unclear.


METHODS
We retrospectively analyzed data and samples collected from 106 radically resected adenosquamous lung carcinoma patients with pathological stage I-IIIA between 2008 and 2013. Correlations between serum tumor marker levels and EGFR mutations as well as survival parameters were analyzed and prognostic factors were identified.


RESULTS
Of the 106 adenosquamous lung carcinoma patients, 29 (27.4%) harbored EGFR mutations. By univariate analysis, advanced clinical stage (P = 0.009 for disease-free survival [DFS]; P = 0.046 for overall survival [OS]), larger tumor size (P = 0.001 for DFS; P = 0.002 for OS), regional lymph node metastasis (P = 0.024 for DFS; P = 0.030 for OS), higher NSE level (P = 0.002 for DFS; P < 0.001 for OS), and higher TMI (tumor marker index) (P = 0.009 for OS) were significantly correlated with a worse prognosis. By multivariate analysis, NSE (P = 0.014) was confirmed as independent predictor for DFS, while NSE (P = 0.001) and TMI (P = 0.038) were independent prognostic factors for OS.


CONCLUSIONS
Adenosquamous lung carcinoma is an aggressive malignancy with relatively high EGFR mutation frequency. Elevated preoperative NSE level and TMI are adverse predictive and prognostic indicators.
Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.|Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin, PR China.
Qiongjie
Q
Zhi
Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.|Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin, PR China.
Yuqian
Y
Wang
Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.|Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin, PR China.
Xinyue
X
Wang
Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.|Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin Medical University, Tianjin, PR China.
Dongsheng
D
Yue
Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.|Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin, PR China.
Kai
K
Li
Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.|Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin, PR China.
Richeng
R
Jiang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D018196:Carcinoma, Adenosquamous / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000097:blood; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009367:Neoplasm Staging; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015843:Serpins / Q000097:blood
D000951:Antigens, Neoplasm; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D015843:Serpins; C102012:antigen CYFRA21.1; C051072:squamous cell carcinoma-related antigen; C512478:EGFR protein, human; D066246:ErbB Receptors; D010751:Phosphopyruvate Hydratase
EGFR mutation; TMI; adenosquamous lung carcinoma; prognostic factor; tumor marker