Department of Thoracic Surgery, Jiangxi Cancer Hospital, Nanchang, Jiangxi, China.
Department of Cardio-Thoracic Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
BMC Cancer. 2023 Aug 30;23(1):812. doi: 10.1186/s12885-023-11312-4.
BACKGROUND: This study aimed to investigate the association between baseline serum tumor markers (STMs) (carcinoembryonic antigen [CEA], neuron-specific enolase [NSE], cytokeratin-19 fragment [CYFRA21-1], carbohydrate antigen 19-9 [CA19-9], and carbohydrate antigen 125 [CA125]) and the efficacy of first-line immunotherapy in patients with advanced non-small cell lung cancer. METHODS: This multicenter retrospective study evaluated patients who received first-line immunotherapy between July 2017 and July 2022. The endpoints were progression-free survival (PFS) and overall survival (OS), as defined by the Response Evaluation Criteria in Solid Tumors version 1.1. We divided the patients into three groups based on STM levels: Group A ≥ threefold upper limit of normal, threefold upper limit of normal > Group B > upper limit of normal, and Group C ≤ upper limit of normal. RESULTS: In total, 716 patients were included in this study. In Cox proportional hazards analyses, the STM levels in Group C were independently associated with superior PFS and OS in patients with lung adenocarcinoma (LUAD). Except for CA19-9 level, the STM levels in Group C were independently associated with superior PFS and OS in patients with lung squamous carcinoma (LUSC). Except for CEA and CA19-9 levels, the levels in Group A were independently associated with inferior PFS and OS in patients with LUAD and LUSC. CONCLUSIONS: Serum CEA, NSE, CYFRA21-1, and CA125 levels can predict PFS and OS in patients with LUAD and LUSC, and serum CA19-9 levels can predict PFS and OS in patients with LUAD. The higher the serum NSE, CYFRA21-1, and CA125 levels, the worse the PFS and OS in patients with LUAD and LUSC. In addition, the higher the serum CA19-9 level, the worse the OS in patients with LUAD.
背景：本研究旨在探讨基线血清肿瘤标志物（CEA、NSE、CYFRA21-1、CA19-9 和 CA125）与晚期非小细胞肺癌患者一线免疫治疗疗效的关系。 方法：本多中心回顾性研究纳入了 2017 年 7 月至 2022 年 7 月期间接受一线免疫治疗的患者。终点为无进展生存期（PFS）和总生存期（OS），采用实体瘤反应评价标准 1.1 版进行定义。我们根据 STM 水平将患者分为三组：A 组≥正常值上限的三倍，三倍正常值上限>B 组>正常值上限，C 组≤正常值上限。 结果：共纳入 716 例患者。在 Cox 比例风险分析中，C 组的 STM 水平与肺腺癌（LUAD）患者的 PFS 和 OS 独立相关。除 CA19-9 水平外，C 组的 STM 水平与肺鳞癌（LUSC）患者的 PFS 和 OS 独立相关。除 CEA 和 CA19-9 水平外，A 组的 STM 水平与 LUAD 和 LUSC 患者的 PFS 和 OS 独立相关。 结论：血清 CEA、NSE、CYFRA21-1 和 CA125 水平可预测 LUAD 和 LUSC 患者的 PFS 和 OS，血清 CA19-9 水平可预测 LUAD 患者的 PFS 和 OS。血清 NSE、CYFRA21-1 和 CA125 水平越高，LUAD 和 LUSC 患者的 PFS 和 OS 越差。此外，血清 CA19-9 水平越高，LUAD 患者的 OS 越差。
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