Predictive and prognostic value of preoperative serum tumor markers in resectable adenosqamous lung carcinoma
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Qiongjie Zhi1,2,3,*, Yuqian Wang1,2,3,*, Xinyue Wang1,2,3*, Dongsheng Yue1,2,4, Kai Li1,2,3 and Richeng Jiang1,2,3
1 Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, PR China
2 Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China
3 Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin, PR China
4 Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Cancer Institute & Hospital, Tianjin Medical University, Tianjin, PR China
* These authors have contributed equally to this work
Richeng Jiang, email:
Kai Li, email:
Keywords: tumor marker, TMI, adenosquamous lung carcinoma, prognostic factor, EGFR mutation
Received: July 18, 2016 Accepted: August 26, 2016 Published: August 30, 2016
Background: Adenosquamous carcinoma is a rare and aggressive form of lung cancer. The prognostic and predictive value of preoperative serum tumor markers and frequency of EGFR mutations in adenosquamous lung carcinoma are unclear.
Methods: We retrospectively analyzed data and samples collected from 106 radically resected adenosquamous lung carcinoma patients with pathological stage I-IIIA between 2008 and 2013. Correlations between serum tumor marker levels and EGFR mutations as well as survival parameters were analyzed and prognostic factors were identified.
Results: Of the 106 adenosquamous lung carcinoma patients, 29 (27.4%) harbored EGFR mutations. By univariate analysis, advanced clinical stage (P = 0.009 for disease-free survival [DFS]; P = 0.046 for overall survival [OS]), larger tumor size (P = 0.001 for DFS; P = 0.002 for OS), regional lymph node metastasis (P = 0.024 for DFS; P = 0.030 for OS), higher NSE level (P = 0.002 for DFS; P < 0.001 for OS), and higher TMI (tumor marker index) (P = 0.009 for OS) were significantly correlated with a worse prognosis. By multivariate analysis, NSE (P = 0.014) was confirmed as independent predictor for DFS, while NSE (P = 0.001) and TMI (P = 0.038) were independent prognostic factors for OS.
Conclusion: Adenosquamous lung carcinoma is an aggressive malignancy with relatively high EGFR mutation frequency. Elevated preoperative NSE level and TMI are adverse predictive and prognostic indicators.
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