Original article: general thoracicEffect of histologic type and smoking status on interpretation of serum carcinoembryonic antigen value in non–small cell lung carcinoma
Section snippets
Material and methods
From January 1985 through December 2002, two series of 694 and 260 consecutive patients with clinical stage I disease were operated on for proven primary adenocarcinoma and squamous cell carcinoma of the lung, respectively. The histologic type of tumor was determined by applying the World Health Organization classification. In all patients, we measured serum CEA before and after surgery and resected the primary tumor. The tumor was measured directly in the surgical specimens. For preoperative
Results
Clinical characteristics, surgical treatment, and pathologic stage are summarized in Table 1. Compared with squamous cell carcinoma patients, adenocarcinoma patients were younger (p < 0.0001), included a higher number of women (p < 0.0001), had a smaller tumor (p < 0.0001), and had higher levels of preoperative serum CEA (p = 0.0018). However, the percentage of preoperative CEA-positive patients was higher in the squamous cell carcinoma group (41.9% versus 35.3%). The two groups were fairly
Comment
Preoperative serum CEA value had independent prognostic value after adjusting for sex, age, tumor size, and histologic type as evaluated in patients treated surgically for clinical stage I non–small cell lung cancer. Its increase was related to clinically and statistically significant reduction in survival even after intentional curative resection for early-stage disease. Although serum CEA value does not appear to be a specific marker of lung cancer, it is an essential prognostic factor. Thus,
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