Associations between serum carcinoembryonic antigen levels and adenocarcinoma subtypes of the lung

Abstract

Abstract Background Increased serum carcinoembryonic antigen (CEA) levels have been associated with a poor outcome in lung cancer. The aim of this study was to further clarify the associations between CEA levels and adenocarcinoma subtypes. Patients and methods We retrospectively assessed preoperative serum CEA levels and clinicopathological factors in 307 consecutive patients who underwent resection for primary lung adenocarcinoma with curative intent. Results Subtypes included adenocarcinoma in situ (AIS) in 20 cases, minimally invasive adenocarcinoma (MIA) in 20, invasive mucinous adenocarcinoma (IMA) in three, lepidic predominant adenocarcinoma ( LPA ) in 41, papillary predominant adenocarcinoma (PPA) in 106, acinar predominant adenocarcinoma (APA) in 90, solid predominant adenocarcinoma (SPA) in 23, and micropapillary predominant adenocarcinoma (MPA) in four. Serum CEA levels varied according to gender, age, smoking status, clinical stage, lymph node metastasis, pathological stage, and adenocarcinoma subtype. Serum CEA levels were higher in the APA, MPA, IMA, and SA subtypes than in the AIS, MIA, PPA, and LPA subtypes. Multiple regression analysis revealed that the clinical stage and adenocarcinoma subtype were significantly associated with serum CEA levels. Univariate analysis demonstrated that preoperative CEA levels were significantly associated with both the postoperative disease-free survival (DFS) and overall survival. Cox regression analysis revealed that the clinical stage and adenocarcinoma subtype were significantly associated with the postoperative DFS. Conclusion The serum CEA level was elevated in advanced disease stages and certain adenocarcinoma subtypes, suggesting the usefulness of CEA as a marker reflecting the malignant behavior of lung adenocarcinomas.