Frontiers in Oncology (Jun 2021)

The Prognostic Value of Preoperative Serum Tumor Markers in Non-Small Cell Lung Cancer Varies With Radiological Features and Histological Types

  • Haiqing Chen,
  • Haiqing Chen,
  • Haiqing Chen,
  • Fangqiu Fu,
  • Fangqiu Fu,
  • Fangqiu Fu,
  • Yue Zhao,
  • Yue Zhao,
  • Yue Zhao,
  • Haoxuan Wu,
  • Haoxuan Wu,
  • Haoxuan Wu,
  • Hong Hu,
  • Hong Hu,
  • Hong Hu,
  • Yihua Sun,
  • Yihua Sun,
  • Yihua Sun,
  • Yawei Zhang,
  • Yawei Zhang,
  • Yawei Zhang,
  • Jiaqing Xiang,
  • Jiaqing Xiang,
  • Jiaqing Xiang,
  • Yang Zhang,
  • Yang Zhang,
  • Yang Zhang

DOI
https://doi.org/10.3389/fonc.2021.645159
Journal volume & issue
Vol. 11

Abstract

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ObjectivesTo assess the association between common-used serum tumor markers and recurrence of lung adenocarcinoma and squamous cell carcinoma separately and determine the prognostic value of serum tumor markers in lung adenocarcinoma featured as ground glass opacities.MethodsA total of 2,654 non-small cell lung cancer patients undergoing surgical resection between January 2008 and September 2014 were analyzed. The serum levels of carcinoma embryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153) and carbohydrate antigen 199 (CA199) were tested preoperatively. Survival analyses were performed with COX proportional hazard regression.ResultsAmong patients with lung adenocarcinoma, elevated preoperative serum CEA(HR=1.246, 95%CI:1.043-1.488, P=0.015), CYFRA21-1(HR=1.209, 95%CI:1.015-1.441, P=0.034) and CA125(HR=1.361, 95%CI:1.053-1.757, P=0.018) were significantly associated with poorer recurrence free survival (RFS). Elevated preoperative serum CA199 predicted worse RFS in patients diagnosed with lung squamous cell carcinoma (HR=1.833, 95%CI: 1.216-2.762, P=0.004). Preoperative serum CYFRA21-1(HR=1.256, 95%CI:1.044-1.512, P=0.016) and CA125(HR=1.373, 95%CI: 1.050-1.795, P=0.020) were independent prognostic factors for patients with adenocarcinoma presenting as solid nodules while serum CEA (HR=2.160,95%CI:1.311-3.558, P=0.003) and CA125(HR=2.475,95%CI:1.163-5.266, P=0.019) were independent prognostic factors for patients with adenocarcinoma featured as ground glass opacities.ConclusionsThe prognostic significances of preoperative serum tumor markers in non-small cell lung cancer were associated with radiological features and histological types.

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