Limits...
The Significance of Serum Carcinoembryonic Antigen in Lung Adenocarcinoma.

Kim JJ, Hyun K, Park JK, Moon SW - Korean J Thorac Cardiovasc Surg (2015)

Bottom Line: Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test).Postoperative CEA level was also significantly associated with disease-free survival (p<0.001).A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine.

ABSTRACT

Background: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma.

Methods: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013.

Results: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis.

Conclusion: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.

No MeSH data available.


Related in: MedlinePlus

Disease-free survival (i.e., recurrence-free survival) according to preoperative carcinoembryonic antigen (CEA) levels. DFS of the normal preoperative CEA group is significantly higher than that of the high preoperative CEA group (p=0.001, log-rank test).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4622033&req=5

f2-kjtcv-48-335: Disease-free survival (i.e., recurrence-free survival) according to preoperative carcinoembryonic antigen (CEA) levels. DFS of the normal preoperative CEA group is significantly higher than that of the high preoperative CEA group (p=0.001, log-rank test).

Mentions: The incidence of patients with high preoperative CEA levels was 28.5%. Along with the low incidence of a high pre-operative CEA level, we found that the preoperative CEA levels were significantly associated with age; smoking history; pathologic stage including pathologic tumor (pT), pathologic nodal (pN) stage, and overall pathologic stage (IA, IB, IIA, IIB, and IIIA); tumor size; tumor grading (differentiation of cancer cells); number of pathologically positive total lymph nodes, N1 lymph nodes, N2 lymph nodes, and N2 nodal stations; and DFS rate. Preoperative CEA levels of smokers were higher than those of non-smokers (1.44 vs. 2.40 ng/mL; p=0.010; Mann-Whitney U test). Preoperative CEA levels were positively associated with age (p=0.009, Spearman’s rho test), pT stage, pN stage, and the overall pathologic stage (p<0.001, p=0.023, and p=0.001, respectively; Jonckheere-Terpstra test) (Fig. 1), tumor size (p=0.001, Spearman’s rho test), pathologically positive total lymph nodes (p=0.007, Spearman’s rho test), pathologically positive N1 and N2 lymph nodes (p=0.040 and p=0.017, respectively; Spearman’s rho test), pathologically positive N2 lymph nodal stations (p=0.019, Jonckheere–Terpstra test), and poorer differentiation well/moderate/poor=1.59/2.20/2.26 ng/mL; p=0.003; Jonckheere–Terpstra test). The DFS of patients with a normal pre-operative CEA level was significantly higher than that of patients with a high preoperative CEA level (0.591 vs. 0.40; p=0.001; log-rank test) (Fig. 2). The results of a univariate analysis of preoperative CEA are summarized in Table 2.


The Significance of Serum Carcinoembryonic Antigen in Lung Adenocarcinoma.

Kim JJ, Hyun K, Park JK, Moon SW - Korean J Thorac Cardiovasc Surg (2015)

Disease-free survival (i.e., recurrence-free survival) according to preoperative carcinoembryonic antigen (CEA) levels. DFS of the normal preoperative CEA group is significantly higher than that of the high preoperative CEA group (p=0.001, log-rank test).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4622033&req=5

f2-kjtcv-48-335: Disease-free survival (i.e., recurrence-free survival) according to preoperative carcinoembryonic antigen (CEA) levels. DFS of the normal preoperative CEA group is significantly higher than that of the high preoperative CEA group (p=0.001, log-rank test).
Mentions: The incidence of patients with high preoperative CEA levels was 28.5%. Along with the low incidence of a high pre-operative CEA level, we found that the preoperative CEA levels were significantly associated with age; smoking history; pathologic stage including pathologic tumor (pT), pathologic nodal (pN) stage, and overall pathologic stage (IA, IB, IIA, IIB, and IIIA); tumor size; tumor grading (differentiation of cancer cells); number of pathologically positive total lymph nodes, N1 lymph nodes, N2 lymph nodes, and N2 nodal stations; and DFS rate. Preoperative CEA levels of smokers were higher than those of non-smokers (1.44 vs. 2.40 ng/mL; p=0.010; Mann-Whitney U test). Preoperative CEA levels were positively associated with age (p=0.009, Spearman’s rho test), pT stage, pN stage, and the overall pathologic stage (p<0.001, p=0.023, and p=0.001, respectively; Jonckheere-Terpstra test) (Fig. 1), tumor size (p=0.001, Spearman’s rho test), pathologically positive total lymph nodes (p=0.007, Spearman’s rho test), pathologically positive N1 and N2 lymph nodes (p=0.040 and p=0.017, respectively; Spearman’s rho test), pathologically positive N2 lymph nodal stations (p=0.019, Jonckheere–Terpstra test), and poorer differentiation well/moderate/poor=1.59/2.20/2.26 ng/mL; p=0.003; Jonckheere–Terpstra test). The DFS of patients with a normal pre-operative CEA level was significantly higher than that of patients with a high preoperative CEA level (0.591 vs. 0.40; p=0.001; log-rank test) (Fig. 2). The results of a univariate analysis of preoperative CEA are summarized in Table 2.

Bottom Line: Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test).Postoperative CEA level was also significantly associated with disease-free survival (p<0.001).A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine.

ABSTRACT

Background: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma.

Methods: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013.

Results: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis.

Conclusion: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.

No MeSH data available.


Related in: MedlinePlus