Division of Respiratory and Allergy, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, College of Medicine, Soonchunhyang University, Wonmi-gu, Bucheon-si, Gyeonggi-do, Korea.
Department of Organ transplantation center, Vinmec Hospital, Vietnam.
Cancer Biomark. 2018;22(1):55-62. doi: 10.3233/CBM-170885.
Serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21-1) levels are prognostic predictors in non-small cell lung cancer (NSCLC). However, even in patients with the same stage of cancer, the serum levels of those markers often vary.
We investigated the association between the initial biomarker levels and prognosis.
We retrospectively reviewed 445 patients with advanced NSCLC and their baseline serum CEA and CYFRA 21-1 levels. Patients were divided into four groups according to the initial levels of those markers: the NN, HN, NH, and HH group. Kaplan-Meier survival analysis with Log-rank test and Cox proportional hazards regression analysis were performed.
The 5-year overall survival (OS) rate in the HN group was the highest (32.2%). Multivariate analyses indicated that the HN group (HR 0.520, 95% CI 0.309-0.878, P= 0.014), female sex (HR 0.685, 95% CI 0.498-0.944, P= 0.021), serum CRP level (HR 1.057, 95% CI 1.034-1.080, P< 0.001), chemotherapy (HR 0.324, 95% CI 0.228-0.460, P< 0.001), and chemotherapy/radiotherapy (HR 0.266, 95% CI 0.171-0.414, P< 0.001) were independent prognostic factors for overall survival.
In advanced NSCLC, patients with baseline high serum CEA but low CYFRA 21-1 level have a significant longer overall survival regardless of clinical stage.
血清癌胚抗原（CEA）和细胞角蛋白 19 片段（CYFRA 21-1）水平是非小细胞肺癌（NSCLC）的预后预测指标。然而，即使在癌症分期相同的患者中，这些标志物的血清水平也经常存在差异。
我们研究了初始生物标志物水平与预后之间的关系。
我们回顾性分析了 445 例晚期 NSCLC 患者及其基线血清 CEA 和 CYFRA 21-1 水平。根据这些标志物的初始水平，患者被分为四组：NN 组、HN 组、NH 组和 HH 组。采用 Kaplan-Meier 生存分析和 Log-rank 检验以及 Cox 比例风险回归分析进行分析。
HN 组的 5 年总生存率（OS）最高（32.2%）。多变量分析表明，HN 组（HR 0.520，95%CI 0.309-0.878，P=0.014）、女性（HR 0.685，95%CI 0.498-0.944，P=0.021）、血清 CRP 水平（HR 1.057，95%CI 1.034-1.080，P<0.001）、化疗（HR 0.324，95%CI 0.228-0.460，P<0.001）和化疗/放疗（HR 0.266，95%CI 0.171-0.414，P<0.001）是总生存的独立预后因素。
在晚期 NSCLC 中，无论临床分期如何，基线时血清 CEA 高但 CYFRA 21-1 水平低的患者总生存时间显著延长。
