Carcinoembryonic antigen as prognostic factor for metastatic non-small cell lung cancer by percutaneous cryosurgery

Article type: Research Article

Authors: Li, Haibo^{a; c; 1} | Tang, Kui^{a; 1} | Niu, Lizhi^{a; b; 1} | Liang, Yingqing^a | Li, Jialiang^{b; c; *} | Chen, Jibing^{a; b; *} | Xu, Kecheng^{a; b}

Affiliations: [a] Fuda Cancer Hospital, Jinan University School of Medicine, Guangzhou, Guangdong, China | [b] Fuda Institute of Lung Cancer, Guangzhou, Guangdong, China | [c] Fuda Institute of Cryosurgery for Cancer, Guangzhou, Guangdong, China

Correspondence: [*] Corresponding authors: Chen Jibing and Li Jialiang, Fuda Cancer Hospital, Jinan University School of Medicine, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510665, Guangdong, China. E-mail: [email protected].

Note: [1] These authors contributed equally to this work and share first authorship.

Abstract: Carcinoembryonic antigen (CEA) is a prognostic marker for early-stage non-small cell lung cancer (NSCLC), and cryoablation is a new therapeutic alternative for lung cancer. We determined whether cryoablation-induced changes in serum CEA levels correlated with tumor type (adenocarcinoma or squamous carcinoma) and treatment type (comprehensive therapy [cryoablation of all intra- and extrapulmonary tumors] or palliative therapy [cryoablation of only extrapulmonary tumors]) in patients with metastatic NSCLC, and assessed whether pre-treatment CEA levels predicted overall survival (OS). We retrospectively reviewed the clinical data of 88 patients with metastatic NSCLC who underwent comprehensive (62 patients) or palliative (26 patients) therapy. Pre- and post-cryoablation serum CEA levels and overall survival were determined for all patients. Cryoablation significantly reduced CEA levels in adenocarcinoma, but not squamous carcinoma, patients. Among adenocarcinoma patients, the cryoablation-induced reduction in CEA levels was significantly greater after comprehensive treatment than after palliative treatment; the OS of patients under comprehensive cryoablation was longer than those under palliative treatment. Among adenocarcinoma patients receiving comprehensive cryoablation, OS was significantly longer in those with normal pre-treatment serum CEA levels than in those with abnormal pre-treatment serum CEA levels. Pretreatment level and change of serum CEA can be a good indicator for therapeutic effects and OS in metastatic NSCLC patients under percutaneous cryosurgery.

Keywords: Cryosurgery, carcinoembryonic antigen, metastatic non-small cell lung cancer

DOI: 10.3233/CBM-130368

Journal: Cancer Biomarkers, vol. 13, no. 5, pp. 337-343, 2013