• Internal medicine journal · May 2019

    Correlation between pre-treatment serum carcinoembryonic antigen levels and genotypes in a large population of Chinese people with advanced lung adenocarcinoma.

    • Jie Liu, Yan-Qiu Zhao, Xiao Han, Xiu-Feng Hu, Hong-Bo Wu, Li-Juan Chen, and Yong-Ping Song.
    • Department of Internal Medicine, The Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China.
    • Intern Med J. 2019 May 1; 49 (5): 634643634-643.

    BackgroundA positive correlation between serum carcinoembryonic antigen (CEA) levels and epidermal growth factor receptor (EGFR) mutations has been reported in lung adenocarcinoma patients.AimTo investigate retrospectively whether serum CEA levels are also associated with genotypes in a large population of advanced lung adenocarcinoma.MethodsA large cohort of 701 patients with advanced lung adenocarcinoma was studied retrospectively.ResultsEGFR mutations were found in 47.5% (333/701) of advanced lung adenocarcinoma patients, being identified at high frequencies in never-smokers, females, and in patients with abnormal pre-treatment serum CEA levels (53.1% vs 37.5%, P < 0.001). In contrast, anaplastic lymphoma kinase gene rearrangements were found in 7.8% (55/701) of patients, being identified at high frequencies in younger patients, and in patients with normal CEA levels (11.5% vs 5.8%, P = 0.012). Serum CEA levels were divided into four groups: <5, 5-19, 20-99 and ≥100 ng/mL. The rate of EGFR mutations significantly increased as the serum CEA levels increased (37.5%, 49.5%, 53.9% and 57.7%, respectively, P < 0.001). Anaplastic lymphoma kinase gene rearrangements showed the opposite result (11.5%, 7.1%, 5.7% and 4.1%, respectively, P = 0.044). A multivariate analysis revealed that higher pre-treatment serum CEA levels were independently associated with EGFR mutations (95% CI: 1.291-2.487, P < 0.001), but normal serum CEA levels were independently associated with anaplastic lymphoma kinase gene rearrangements (95% CI: 0.275-0.842, P = 0.010).ConclusionOur study demonstrated that a significant association exists between the serum CEA levels and genotypes in patients with advanced lung adenocarcinoma.© 2018 Royal Australasian College of Physicians.

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