Value of combining serum carcinoembryonic antigen and PET/CT in predicting mutation in non-small cell lung cancer.

BACKGROUND

We sought to investigate the associations between pretreatment serum Carcinoembryonic antigen (CEA) level, F-Fluoro-2-deoxyglucose (F-FDG) uptake value of primary tumor and epidermal growth factor receptor () mutation status in non-small cell lung cancer (NSCLC).

METHODS

We retrospectively reviewed medical records of 210 NSCLC patients who underwent mutation test and F-FDG positron emission tomography/computed tomography (PET/CT) scan before anti-tumor therapy. The associations between mutations and patients' characteristics, serum CEA, PET/CT imaging characteristics maximal standard uptake value (SUVmax) of the primary tumor were analyzed. Receiver-operating characteristic (ROC) curve was used to assess the predictive value of these factors.

RESULTS

mutations were found in 70 patients (33.3%). mutations were more common in high CEA group (CEA ≥7.0 ng/mL) than in low CEA group (CEA <7.0 ng/mL) (40.4% . 27.6%; P=0.05). Females (P<0.001), non-smokers (P<0.001), patients with adenocarcinoma (P<0.001) and SUVmax <9.0 (P=0.001) were more likely to be mutation-positive. Multivariate analysis revealed that gender, tumor histology, pretreatment serum CEA level, and SUVmax were the most significant predictors for mutations. The ROC curve revealed that combining these four factors yielded a higher calculated AUC (0.80).

CONCLUSIONS

Gender, histology, pretreatment serum CEA level and SUVmax are significant predictors for mutations in NSCLC. Combining these factors in predicting mutations has a moderate diagnostic accuracy, and is helpful in guiding anti-tumor treatment.