The relationship between tumor markers and pulmonary embolism in lung cancer

Abstract

BackgroundTumor markers (TMs) and D-Dimer are both hallmarks of severity and prognosis of lung cancer. Tumor markers could be related to pulmonary embolism (PE) in lung cancer.ResultsThe number of abnormal tumor markers of lung cancer patients with pulmonary embolism (3.9 ± 1.1vs1.6 ± 0.6,P 0.005) was more than that in patients without pulmonary embolism. TMs panel (P trend < 0.001), CEA (R2 0.735, P0.003) and CYFRA21-1 (R2 0.718, P0.005) were positively correlated with D-Dimer in patients with pulmonary embolism. The multivariate logistic regression analysis showed that, for tumor markers, TMs panel (OR5.98, P < 0.001) had the strongest correlation with pulmonary embolism. The AUC (area under curve) of TMs panel and CEA were 0.82 [95%CI (0.71–0.95), P < 0.001] and 0.71 [95%CI (0.62–0.84), P 0.002] by ROC (receiver operating characteristic) curve analysis, respectively.Materials and MethodsTumor markers were compared between lung cancer patients complicated with pulmonary embolism and those without pulmonary embolism Then the correlation between each tumor marker as well as panel of combined TMs and D-Dimer as well as pulmonary embolism were analyzed for patients with pulmonary embolism.ConclusionsThere is a relationship between tumor markers and pulmonary embolism in patients with lung cancer. The panel of combined tumor markers is a valuable diagnostic marker for pulmonary embolism in lung cancer.

Lung Cancer and Pulmonary Embolism: What Is the Relationship? A Review

“…In addition, white blood cell (WBC) > 11×10 9 /L, D-dimer > 500 μg/L (OR, 3.15; 95% CI: 2.044-3.863, p = 0.025), PaO 2 < 80 mmHg are respectively the independent risk factors of PE in lung cancer patients 58 . Another two studies also show that different D-dimer levels (865 ± 489 μg/L, OR = 2.7 or 2,670 ± 1,350 μg/L, OR = 6.16) are independent risk factors of PE 57 , 59 , which implies the D-dimer level could be positively associated with the risk of PE.…”

“…Multivariate analysis finds NSCLC is at high risk of PE in lung cancer patients (OR, 2.88; 95% CI: 1.97-3.78, p = 0.008) 57 . In particular, adenocarcinoma, one of subtypes of NSCLC, is an independent risk factor for development of PE in lung cancer patients 32 , 58 - 61 .…”

“…Studies have uncovered some comorbid conditions in patients with lung cancer that can contribute to the development of PE, including anemia (Hemoglobin ≤ 100 g/L) 32 , 58 , 66 , obesity [body mass index (BMI) ≥ 30] among patients with primary lung cancer undergoing lobectomy (1.5% vs. 0.8%, P = 0.005) 67 , chronic obstructive pulmonary disease (COPD) 63 and DVT (OR, 10.62; 95% CI: 4.94-18.08, p < 0.001) 57 . However, Ma et al suggested that comorbidities such as diabetes, hypertension, pulmonary tuberculosis and cardiovascular disease were not risk factors of PE in patients with lung cancer (p > 0.05) 59 .…”

Comparison among different presentations of venous thromboembolism because of lung cancer

“…Nevertheless, the next comparison encompassing histopathology, stage, oncological therapy and the level of D-Dimer as well as CEA demonstrated that, concomitance group had more adenocarcinoma, metastasis, chemotherapy and severer thrombosis as well as tumor markers by contrast with the other two, especially DVT group. Since adenocarcinoma, metastasis, chemotherapy, elevated D-Dimer as well as CEA are all facilitating factors for VTE because of lung cancer, 12,[15][16][17][18][19][20] obviously no wonder concomitance group manifested both presentations of VTE, whereas DVT group merely presented the mildest and stablest appearance of VTE. From another perspective, concomitance of DVT and PE represented the severest condition of lung cancer and highest risk of VTE, conversely did the DVT group.…”

“…Then we performed a comparison analysis between chemotherapy group and non-chemotherapy group since chemotherapy was the major regimen after the diagnosis of VTE, the results demonstrated that, notwithstanding the K-M curve of chemotherapy group was slightly higher than that of non-chemotherapy group, the cumulative survival rates were statistically similar between the two groups. In a serial of previous studies, chemotherapy has been well acknowledged as a promoting factor in the development of VTE because of lung cancer for a long time, 9,[15][16][17][18][19][20] however, the role of chemotherapy in lung cancer with developed VTE was seldom defined. In this study, the results indicated that by contrast with non-chemotherapy group, chemotherapy was not beneficial to achieve a better survival in patients with VTE because of lung cancer.…”