İleri Evre Küçük Hücreli Dışı Akciğer Kanserlerinde Karsinoembriyonik Antijen Düzeyinin Tedavi Yanıtı ile İlişkisi
Abstract
Amaç:
Serum karsinoembriyonik antijenin (CEA) yüksek düzeyleri, birçok kanser türünde kötü prognoz ile ilişkilendirilmiştir. Çalışmamızın amacı, ileri evre küçük hücreli dışı akciğer kanseri (KHDAK)’de tedavi öncesi ve sonrası serum CEA düzeylerinin tedaviye yanıt oranları ve yaşam süresiyle ilişkisini araştırmaktır.
Materiyal- Metod:
Çalışma tek merkezli, prospektif kohort olarak dizayn edildi ve toplam 85 hasta araştırıldı. İleri evre KHDAK (Evre IIIA/IIIB ve IV) tanılı 60 olguda, tedavi öncesi ve 2 kür kemoterapi sonrası serum CEA düzeyleri ile 25 sağlıklı bireyden oluşan kontrol grubundaki serum CEA düzeyleri karşılaştırıldı.
Bulgular:
KHDAK grubunda median serum CEA düzeyi 36.2 ng/ml, kontrol grubunda ise 3,65 ng/ml idi (p< 0.01). Olguların 2 kür kemoterapi sonrası RECİST kriterlerine göre yanıt değerlendirmesi yapıldı ve 23 (%38) olguda parsiyel yanıt, 19 (%32) olguda stabil hastalık ve 18 (%30) olguda progresif yanıt olarak değerlendirildi. Progresif hastalık grubunda, tedavi sonrası serum CEA düzeyleri, stabil ve parsiyel yanıt grubuna göre daha yüksekti (p=0.023).
Sonuç:
İleri evre KHDAK’de, kontrol grubuna göre serum CEA düzeylerinin yüksek olduğu ve serum CEA düzeylerinin progresif hastalık ile ilişkili olduğu bulundu. KHDAK’inde serum CEA düzeyi, tedavi yanıtı ve prognozu öngörmede kullanılabilecek bir parametre olabileceği gösterildi.
Keywords
Supporting Institution
Yok
Project Number
Yok
Thanks
Yok
References
- 1. Novello S, Barlesi F, Califano R. Metastatic nonsmallcell lung cancer: ESMO Clinical practice Guidelines for diagnosis, treatment, and follow up. Ann Oncol. 2016;27:1-27.
- 2. Gridelli C, Rossi A, Maione P. Treatment of non-small-cell lung cancer: state of the art and development of new biologic agents. Oncogene. 2003;22:6629-38.
- 3. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359-86.
- 4. Ganti AK, Mulshine JL. Lung cancer screening. Oncologist. 2006;11:481–7.
- 5. Grunnet M, Sorensen JB. Carcinoembryonic antigen (CEA) as tumor marker in lung cancer. Lung Cancer. 2012;76:138-43.
- 6. Alexander JC, Silverman NA, Chretien PB. Effect of age and cigarette smoking on carcinoembryonic antigen levels. JAMA. 1976;235:1975-9.
- 7. Ruibal Morell A. CEA serum levels in non-neoplastic disease. Int J Biol Markers. 1992;7:160-6.
- 8. Duffy MJ, Lamerz R, Haglund C, Nicolini A, Kalousová M, Holubec L, et al. Tumor markers in colorectal cancer, gastric cancer and gastrointestinal stromal cancers: European group on tumor markers 2014 guidelines update. Int J Cancer. 2014;134:2513-22.
- 9. Arrieta O, Villarreal-Garza C, Martínez-Barrera L, Morales M, Dorantes-Gallareta Y, Peña-Curiel O, et al. Usefulness of serum carcinoembryonic antigen (CEA) in evaluating response to chemotherapy in patients with advanced non small-cell lung cancer: a prospective cohort study. BMC Cancer. 2013;13:254.
- 10. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205-16.
- 11. Okamura K, Takayama K, Izumi M, Harada T, Furuyama K, Nakanishi Y. Diagnostic value of CEA and CYFRA 21-1 tumor markers in primary lung cancer. Lung Cancer. 2013;80:45-9.
- 12. Tomita M, Shimizu T, Ayabe T, Yonei A, Onitsuka T. Prognostic significance of tumour marker index based on preoperative CEA and CYFRA 21-1 in non-small cell lung cancer. Anticancer Research. 2010;30:3099-102.
- 13. Shintani T, Matsuo Y, Iizuka Y, Mitsuyoshi T, Mizowaki T, Hiraoka M. prognostic significance of serum CEA for non-small cell lung cancer patients receiving stereotactic body radiotherapy. Anticancer Res. 2017;37:5161-7.
- 14. Song WA, Liu X, Tian XD, Wang W, Liang CY, Zhang T, et al. Utility of squamous cell carcinoma antigen, carcinoembryonic antigen, Cyfra 21-1 and neuron specific enolase in lung cancer diagnosis: a prospective study from China. Chin Med J (Engl). 2011;124:3244-8.
- 15. Duan X, Cui Y, Li H, Shi G, Wu B, Liu M, et al. High preoperative and postoperative levels of carcinoembryonic antigen and CYFRA 21-1 indicate poor prognosis in patients with pathological Stage I nonsmall cell lung cancer. Indian J Cancer. 2015;52 Suppl 3:E158-63.
- 16. Nasralla, A, Lee J, Dang J, Turner S. Elevated preoperative CEA is associated with subclinical nodal involvement and worse survival in stage I non-small cell lung cancer: a systematic review and meta-analysis. J Cardiothorac Surg 2010;15:318.
- 17. Holdenrieder S, Wehnl B, Hettwer K, Simon K, Uhlig S, Dayyani F. Carcinoembryonic antigen and cytokeratin-19 fragments for assessment of therapy response in non-small cell lung cancer: a systematic review and meta-analysis. BJC. 2017:116;1037-45.
- 18. Wan Z. Association of divergent carcinoembryonic antigen. patterns and lung cancer progression. Sci Rep. 2020;10:2066.
- 19. Liu H, Xiaoling G, Tangfeng L, Ying W, Yongying X, Dongmei Y, et al. The role of serum carcinoembryonic antigen in predicting responses to chemotherapy and survival in patients with non-small cell lung cancer. J Cancer Research and Therapeutics. 2014;10:239-43.
- 20. He G, Jiang Z, Xue S, Sun X, Wang W. Expression of LDH and CEA in serum in the process of targeted therapy of lung adenocarcinoma and the association between them and prognosis. Oncol Lett. 2019;17:4550–6.
- 21. Numata T, Endo T, Yanai H, Ota K, Yamamoto Y, Shimizu K, et al. Serum CEA and CYFRA levels in ALK-rearranged NSCLC patients: correlation with distant metastasis. In Vivo. 2020;34:2095-100.
- 22. Pakdel A, Malekzadeh M, Naghibalhossaini F. The association between preoperative serum CEA concentrations and synchronous liver metastasis in colorectal cancer patients. Cancer Biomark. 2016;16:245-52.
- 23. Gao XC, Wei CH, Zhang RG, Cai Q, He Y, Tong F, et al. 18F-FDG PET/CT SUVmax and serum CEA levels as predictors for EGFR mutation state in Chinese patients with non-small cell lung cancer. Oncol Lett. 2020;20:61.
- 24. Kuo, YS, Zheng MZ, Huang MF, Miao CC, Yang LH, Huang TW. Chou association of divergent carcinoembryonic antigen patterns and lung cancer progression. Sci Rep. 2020;10:2066.
THE RELATIONSHIP OF CEA LEVEL WITH THE TREATMENT RESPONSE IN ADVANCED STAGE NON-SMALL CELL LUNG CANCER
Abstract
Objective:
High levels of serum carcinoembryonic antigen (CEA) have been associated with poor prognosis in many types of cancer. The aim of our study is to investigate the relationship between pre- and post-treatment serum CEA levels, response rates to treatment and survival in advanced non-small cell lung cancer (NSCLC).
Material- Method:
The study was designed as a single-center, prospective cohort, and a total of 85 patients were investigated. Serum CEA levels before and after 2 cycles of chemotherapy in 60 patients with advanced NSCLC (Stage IIIA/IIIB and IV) were compared with serum CEA levels in the control group of 25 healthy individuals.
Results:
The median serum CEA level was 36.2 ng/ml in the NSCLC group and 3.65 ng/ml in the control group (p< 0.01). Response was evaluated according to RECIST criteria after 2 cycles of chemotherapy and it was evaluated as partial response in 23 (38%) patients, stable disease in 19 (32%) patients, and progressive response in 18 (30%) patients. Post-treatment serum CEA levels were higher in the progressive disease group than in the stable and partial response group (p=0.023).
Conclusion:
It was found that serum CEA levels were higher in advanced NSCLC compared to the control group and serum CEA levels were associated with progressive disease. It has been shown that serum CEA level can be a parameter that can be used to predict treatment response and prognosis in NSCLC.
Keywords
Project Number
Yok
References
- 1. Novello S, Barlesi F, Califano R. Metastatic nonsmallcell lung cancer: ESMO Clinical practice Guidelines for diagnosis, treatment, and follow up. Ann Oncol. 2016;27:1-27.
- 2. Gridelli C, Rossi A, Maione P. Treatment of non-small-cell lung cancer: state of the art and development of new biologic agents. Oncogene. 2003;22:6629-38.
- 3. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359-86.
- 4. Ganti AK, Mulshine JL. Lung cancer screening. Oncologist. 2006;11:481–7.
- 5. Grunnet M, Sorensen JB. Carcinoembryonic antigen (CEA) as tumor marker in lung cancer. Lung Cancer. 2012;76:138-43.
- 6. Alexander JC, Silverman NA, Chretien PB. Effect of age and cigarette smoking on carcinoembryonic antigen levels. JAMA. 1976;235:1975-9.
- 7. Ruibal Morell A. CEA serum levels in non-neoplastic disease. Int J Biol Markers. 1992;7:160-6.
- 8. Duffy MJ, Lamerz R, Haglund C, Nicolini A, Kalousová M, Holubec L, et al. Tumor markers in colorectal cancer, gastric cancer and gastrointestinal stromal cancers: European group on tumor markers 2014 guidelines update. Int J Cancer. 2014;134:2513-22.
- 9. Arrieta O, Villarreal-Garza C, Martínez-Barrera L, Morales M, Dorantes-Gallareta Y, Peña-Curiel O, et al. Usefulness of serum carcinoembryonic antigen (CEA) in evaluating response to chemotherapy in patients with advanced non small-cell lung cancer: a prospective cohort study. BMC Cancer. 2013;13:254.
- 10. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205-16.
- 11. Okamura K, Takayama K, Izumi M, Harada T, Furuyama K, Nakanishi Y. Diagnostic value of CEA and CYFRA 21-1 tumor markers in primary lung cancer. Lung Cancer. 2013;80:45-9.
- 12. Tomita M, Shimizu T, Ayabe T, Yonei A, Onitsuka T. Prognostic significance of tumour marker index based on preoperative CEA and CYFRA 21-1 in non-small cell lung cancer. Anticancer Research. 2010;30:3099-102.
- 13. Shintani T, Matsuo Y, Iizuka Y, Mitsuyoshi T, Mizowaki T, Hiraoka M. prognostic significance of serum CEA for non-small cell lung cancer patients receiving stereotactic body radiotherapy. Anticancer Res. 2017;37:5161-7.
- 14. Song WA, Liu X, Tian XD, Wang W, Liang CY, Zhang T, et al. Utility of squamous cell carcinoma antigen, carcinoembryonic antigen, Cyfra 21-1 and neuron specific enolase in lung cancer diagnosis: a prospective study from China. Chin Med J (Engl). 2011;124:3244-8.
- 15. Duan X, Cui Y, Li H, Shi G, Wu B, Liu M, et al. High preoperative and postoperative levels of carcinoembryonic antigen and CYFRA 21-1 indicate poor prognosis in patients with pathological Stage I nonsmall cell lung cancer. Indian J Cancer. 2015;52 Suppl 3:E158-63.
- 16. Nasralla, A, Lee J, Dang J, Turner S. Elevated preoperative CEA is associated with subclinical nodal involvement and worse survival in stage I non-small cell lung cancer: a systematic review and meta-analysis. J Cardiothorac Surg 2010;15:318.
- 17. Holdenrieder S, Wehnl B, Hettwer K, Simon K, Uhlig S, Dayyani F. Carcinoembryonic antigen and cytokeratin-19 fragments for assessment of therapy response in non-small cell lung cancer: a systematic review and meta-analysis. BJC. 2017:116;1037-45.
- 18. Wan Z. Association of divergent carcinoembryonic antigen. patterns and lung cancer progression. Sci Rep. 2020;10:2066.
- 19. Liu H, Xiaoling G, Tangfeng L, Ying W, Yongying X, Dongmei Y, et al. The role of serum carcinoembryonic antigen in predicting responses to chemotherapy and survival in patients with non-small cell lung cancer. J Cancer Research and Therapeutics. 2014;10:239-43.
- 20. He G, Jiang Z, Xue S, Sun X, Wang W. Expression of LDH and CEA in serum in the process of targeted therapy of lung adenocarcinoma and the association between them and prognosis. Oncol Lett. 2019;17:4550–6.
- 21. Numata T, Endo T, Yanai H, Ota K, Yamamoto Y, Shimizu K, et al. Serum CEA and CYFRA levels in ALK-rearranged NSCLC patients: correlation with distant metastasis. In Vivo. 2020;34:2095-100.
- 22. Pakdel A, Malekzadeh M, Naghibalhossaini F. The association between preoperative serum CEA concentrations and synchronous liver metastasis in colorectal cancer patients. Cancer Biomark. 2016;16:245-52.
- 23. Gao XC, Wei CH, Zhang RG, Cai Q, He Y, Tong F, et al. 18F-FDG PET/CT SUVmax and serum CEA levels as predictors for EGFR mutation state in Chinese patients with non-small cell lung cancer. Oncol Lett. 2020;20:61.
- 24. Kuo, YS, Zheng MZ, Huang MF, Miao CC, Yang LH, Huang TW. Chou association of divergent carcinoembryonic antigen patterns and lung cancer progression. Sci Rep. 2020;10:2066.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Project Number | Yok |
| Publication Date | March 18, 2024 |
| Submission Date | March 5, 2023 |
| Published in Issue | Year 2024 Volume: 3 Issue: 1 |
Cite
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.