PDF(Pubmed)
Abstract：
Conventional tumor markers may serve as adjuncts in non-small cell lung cancer (NSCLC) management. This study analyzed whether three tumor markers (CEA, CA19-9, and CA-125) held associations with radiographic and clinical outcomes in NSCLC. It constituted a single-center study of NSCLC patients treated with systemic therapy at the London Regional Cancer Program. Serum tumor markers were analyzed for differences in radiographic responses (RECIST v1.1 or iRECIST), associations with clinical characteristics, and all-cause mortality. A total of 533 NSCLC patients were screened, of which 165 met inclusion criteria. A subset of 92 patients had paired tumor markers and radiographic scans. From the latter population, median (IQR) fold-change from nadir to progression was 2.13 (IQR 1.24-3.02; p < 0.001) for CEA, 1.46 (IQR 1.13-2.18; p < 0.001) for CA19-9, and 1.53 (IQR 0.96-2.12; p < 0.001) for CA-125. Median (IQR) fold-change from baseline to radiographic response was 0.50 (IQR 0.27, 0.95; p < 0.001) for CEA, 1.08 (IQR 0.74, 1.61; p = 0.99) for CA19-9, and 0.47 (IQR 0.18, 1.26; p = 0.008) for CA-125. In conclusion, tumor markers are positioned to be used as adjunct tools in clinical decision making, especially for their associations with radiographic response (CEA/CA-125) or progression (CEA/CA-125/CA-19-9).
摘要：
常规肿瘤标志物可作为非小细胞肺癌(NSCLC)治疗的辅助手段。这项研究分析了三种肿瘤标志物(CEA，CA19-9和CA-125）与NSCLC的影像学和临床结果相关。它构成了在伦敦地区癌症计划中接受全身治疗的NSCLC患者的单中心研究。分析血清肿瘤标志物的放射学反应差异（RECISTv1.1或iRECIST），与临床特征相关，和全因死亡率。共筛查533例NSCLC患者，其中165人符合纳入标准。92例患者中的一个子集有配对的肿瘤标志物和影像学扫描。从后者的人口来看，CEA从最低点到进展的中位数（IQR）倍数变化为2.13（IQR1.24-3.02；p<0.001），CA19-9为1.46（IQR1.13-2.18；p<0.001），CA-125为1.53（IQR0.96-2.12；p<0.001）。CEA从基线到影像学响应的中位数（IQR）倍数变化为0.50（IQR0.27，0.95；p<0.001），CA19-9为1.08（IQR0.74，1.61；p=0.99），CA-125为0.47（IQR0.18，1.26；p=0.008）。总之,肿瘤标志物被定位为临床决策中的辅助工具，尤其是它们与影像学反应（CEA/CA-125）或进展（CEA/CA-125/CA-19-9）的关联。
