Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis
| Autor: | Oscar Arrieta, Patricia Castillo, Enrique Guzman, Jaime de la Garza, Alma Astorga, Luis Martinez, Daniel Mendoza-Posada, David Saavedra-Perez, Roberto Kuri, Alejandro Avilés-Salas |
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| Jazyk: | angličtina |
| Předmět: |
Male
Oncology medicine.medical_specialty Cancer Research Lung Neoplasms Receptor ErbB-2 lcsh:RC254-282 Metastasis Carcinoembryonic antigen Carcinoma Non-Small-Cell Lung Internal medicine medicine Carcinoma Genetics Humans Prospective Studies Lung cancer Prospective cohort study Lung Survival analysis Neoplasm Staging Immunoassay biology Brain Neoplasms business.industry Middle Aged Prognosis medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Immunohistochemistry Survival Analysis Carcinoembryonic Antigen ErbB Receptors Luminescent Measurements Multivariate Analysis biology.protein Adenocarcinoma Female business Follow-Up Studies Research Article Brain metastasis |
| Zdroj: | BMC Cancer, Vol 9, Iss 1, p 119 (2009) BMC Cancer |
| ISSN: | 1471-2407 |
| DOI: | 10.1186/1471-2407-9-119 |
| Popis: | Background Central nervous system is a common site of metastasis in NSCLC and confers worse prognosis and quality of life. The aim of this prospective study was to evaluate the prognostic significance of clinical-pathological factors (CPF), serum CEA levels, and EGFR and HER2 tissue-expression in brain metastasis (BM) and overall survival (OS) in patients with advanced NSCLC. Methods In a prospective manner, we studied 293 patients with NSCLC in IIIB-IV clinical stage. They received standard chemotherapy. CEA was measured prior to treatment; EGFR and HER2 were evaluated by immunohistochemistry. BM development was confirmed by MRI in symptomatic patients. Results BM developed in 27, and 32% of patients at 1 and 2 years of diagnosis with adenocarcinoma (RR 5.2; 95% CI, 1.002–29; p = 0.05) and CEA ≥ 40 ng/mL (RR 11.4; 95% CI, 1.7–74; p < 0.01) as independent associated factors. EGFR and HER2 were not statistically significant. Masculine gender (RR 1.4; 95% CI, 1.002–1.9; p = 0.048), poor performance status (RR 1.8; 95% CI, 1.5–2.3; p = 0.002), advanced clinical stage (RR 1.44; 95% CI, 1.02–2; p = 0.04), CEA ≥ 40 ng/mL (RR 1.5; 95% CI, 1.09–2.2; p = 0.014) and EGFR expression (RR 1.6; 95% CI, 1.4–1.9; p = 0.012) were independent associated factors to worse OS. Conclusion High CEA serum level is a risk factor for BM development and is associated with poor prognosis in patients with advanced NSCLC. Surface expression of CEA in tumor cells could be the physiopathological mechanism for invasion to CNS. |
| Databáze: | OpenAIRE |
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