Hsu Wen-Hu, Huang Chien-Sheng, Hsu Han-Shui, Huang Wen-Jen, Lee Hui-Chen, Huang Biing-Shiun, Huang Min-Hsiung
Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Ann Thorac Surg. 2007 Feb;83(2):419-24. doi: 10.1016/j.athoracsur.2006.07.079.
Carcinoembryonic antigen (CEA) is one of the markers evaluated in patients with non-small cell lung cancer (NSCLC). The significance of the preoperative serum CEA level in female patients with NSCLC is seldom discussed. In this study, we conducted a retrospective review to investigate the prognostic significance of the preoperative CEA level in female patients with stage I NSCLC.
In this study, we looked at 163 female patients with stage I NSCLC. Patient charts were reviewed to collect patient data, including the age of the patient, tumor location, tumor size, visceral pleural invasion, the stage of disease, and the preoperative serum CEA level. The cutoff value of serum CEA level was 6.0 ng/mL. The significance of preoperative CEA level in the prognosis of female patients with stage I NSCLC was evaluated.
Among the 163 female patients with stage I NSCLC, 47 patients (28.8%) had abnormal preoperative serum CEA level (>6 ng/mL). Diagnosis of adenocarcinoma and bronchoalveolar carcinoma accounted for 83.4% of these 163 female patients. In-hospital mortality was encountered in 1 patient. Univariate analysis of survival in the other 162 female patients with stage I NSCLC showed that age, stage, tumor size, and preoperative CEA level were prognostic factors. Visceral pleural invasion had no impact on the prognosis of these patients. Multivariate analysis revealed that tumor size and preoperative CEA level were independent prognostic factors in female patients with stage I NSCLC.
Preoperative serum CEA level and tumor size are independent prognostic factors in female patients with stage I NSCLC. In contrast, visceral pleural invasion was not associated with the prognosis. Importantly, these results suggest that female patients with abnormally high preoperative CEA level and tumor size larger than 3 cm may need a thorough preoperative evaluation and careful postoperative follow-up to rule out occult metastasis of early NSCLC.
癌胚抗原（CEA）是评估非小细胞肺癌（NSCLC）患者时所检测的标志物之一。术前血清CEA水平在女性NSCLC患者中的意义鲜少被讨论。在本研究中，我们进行了一项回顾性分析，以探讨术前CEA水平在I期NSCLC女性患者中的预后意义。
在本研究中，我们观察了163例I期NSCLC女性患者。回顾患者病历以收集患者数据，包括患者年龄、肿瘤位置、肿瘤大小、脏层胸膜侵犯情况、疾病分期以及术前血清CEA水平。血清CEA水平的临界值为6.0 ng/mL。评估术前CEA水平在I期NSCLC女性患者预后中的意义。
在这163例I期NSCLC女性患者中，47例（28.8%）术前血清CEA水平异常（>6 ng/mL）。腺癌和细支气管肺泡癌的诊断占这163例女性患者的83.4%。1例患者出现院内死亡。对其他162例I期NSCLC女性患者的生存情况进行单因素分析显示，年龄、分期、肿瘤大小和术前CEA水平是预后因素。脏层胸膜侵犯对这些患者的预后没有影响。多因素分析显示，肿瘤大小和术前CEA水平是I期NSCLC女性患者的独立预后因素。
术前血清CEA水平和肿瘤大小是I期NSCLC女性患者的独立预后因素。相比之下，脏层胸膜侵犯与预后无关。重要的是，这些结果表明，术前CEA水平异常升高且肿瘤大小大于3 cm的女性患者可能需要进行全面的术前评估和仔细的术后随访，以排除早期NSCLC的隐匿转移。
