Value of combining serum carcinoembryonic antigen and PET/CT in predicting EGFR mutation in non-small cell lung cancer

Gu, Jincui; Xu, Siqi; Huang, Lixia; Li, Shaoli; Wu, Jianhui; Xu, Junwen; Feng, Jinlun; Liu, Baomo; Zhou, Yan

doi:10.21037/jtd.2017.12.143

Cited by 20 publications

(17 citation statements)

References 33 publications

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“…In the present study, we found the positive rate of EGFR mutations accounted for about 46.5% (53/114) in lung adenocarcinoma patients with MPE, which was consistent with several other reports reporting EGFR gene mutation rate ranging from 43% to 50% in China ( 13 - 15 ). However, the results of a few other studies much lower ( 16 ).…”

Section: Discussionsupporting

confidence: 93%

Carcinoembryonic antigen in pleural effusion of patients with lung adenocarcinoma: a predictive marker for EGFR mutation

Y¹,

Liu²,

Yuan³

et al. 2019

Transl. Cancer Res.

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Background Carcinoembryonic antigen (CEA) can reflect tumor growth, recurrence and metastasis, and also predict the clinical efficacy of the epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI). In the present study, we investigated the association between CEA in serum and pleural effusion (PE) and EGFR mutations in patients with lung adenocarcinoma. Methods We retrospectively investigated 114 lung adenocarcinoma patients with malignant pleural effusion (MPE). CEA levels in serum and MPE were measured by immunoradiometric assay, we analysed the correlation between CEA and EGFR mutation status. Results Fifty-three cases had EGFR mutation (46.5%). EGFR mutations were more common in females, patients with high levels of PE (≥107.2 ng/mL) and serum CEA (≥87 ng/mL). There was no significant difference in EGFR mutation rate between in tumor tissue and PE samples (49.3% vs. 41.9%, P=0.440). The result of receiver operating characteristic (ROC) indicated that the cut off value of CEA in MPE was 107.2 ng/mL, which had the highest sensitivity (SEN) and specificity (SPE) for predicting EGFR mutation [SEN 66%, and SPE 62.3%, AUC =0.668, 95% confidence interval (CI): 0.569–0.767, P=0.025]. The combination of gender, smoking history, serum and MPE CEA level had a higher calculated AUC (0.718, 95% CI: 0.622–0.813, P=0.000). Moreover, multivariate analysis showed that CEA level in MPE but not in serum was confirmed as the only independent factor associated with EGFR gene mutation status (P=0.026) with an odds ratio of 2.885 (95% CI: 1.137–7.317). Conclusions MPE CEA can probably serve as a predictive marker for EGFR mutation in advanced lung adenocarcinoma. Combining gender, smoking history, and CEA has a relatively better predictive value. However, detecting EGFR mutations in lung adenocarcinomas is necessary for determining EGFR-TKI treatment in clinic.

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Section: Discussionsupporting

confidence: 93%

Carcinoembryonic antigen in pleural effusion of patients with lung adenocarcinoma: a predictive marker for EGFR mutation

Y¹,

Liu²,

Yuan³

et al. 2019

Transl. Cancer Res.

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“…When combining with other accessible factors, an AUC of predicting EGFR mutations could reach 0.84. Several studies [8,[12][13][14][15][16][17][18][19][20][21][22][23] had evaluated the value of FDG uptake for predicting EGFR status in NSCLC. As described in Table 3, the results were not very consistent.…”

Section: Discussionmentioning

confidence: 99%

“…Almost all previous studies solely focused on the pSUVmax. Ten of them [8,[14][15][16][18][19][20][21][22][23] revealed that lower pSUVmax was associated with EGFR mutations, and three studies [8,22,23] found lower pSUVmax was an independent predictor for EGFR mutations by multivariate analysis. Meanwhile, two studies [15,19] demonstrated that high pSUVmax was a significant predictor of EGFR mutations, and one [14] didn't show statistical difference in pSUVmax between different EGFR statuses.…”

Section: Discussionmentioning

confidence: 99%

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Value of combining PET/CT and clinicopathological features in predicting EGFR mutation in Lung Adenocarcinoma with Bone Metastasis

Yao

Zhou

et al. 2020

J. Cancer

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Purpose: Epidermal growth factor receptor (EGFR) mutation is the most common target for precision treatment in metastatic lung adenocarcinoma. We investigated the predictive role of 18 F-FDG PET/CT and clinicopathological features for EGFR mutations in lung adenocarcinoma with bone metastasis. Methods: Seventy-five lung adenocarcinoma patients with histologically confirmed bone metastasis were included. They all received EGFR status test and PET/CT before systemic treatment. The differences of maximum standardized uptake value (SUVmax) in primary tumor (pSUVmax), regional lymph node (nSUVmax) and bone metastasis (bmSUVmax) between different EGFR status groups were compared, alongside with common clinicopathological features. Multivariate logistic regression analysis was performed to evaluate predictors of EGFR mutations. Results: EGFR mutations were found in 37 patients (49.3%). EGFR mutations were more common in females, non-smokers, expression of Thyroid Transcription Factor-1 (TTF-1) and NaspinA. Low bmSUVmax was significantly associated with EGFR mutations, while no significant difference was observed in pSUVmax and nSUVmax. Multivariate analysis showed that bmSUVmax ≤7, non-smoking, expression of TTF-1 were predictors of EGFR mutations. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was 0.84 for the combination of the three factors. Conclusion: Low bmSUVmax is more frequently in EGFR mutations, and bmSUVmax is an independent predictor of EGFR mutations. Combining bmSUVmax with other clinicopathological features could forecast the EGFR status in lung adenocarcinoma with unavailable EGFR gene testing.

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“…Studies have shown mixed results of the correlation between the degree of differentiation and EGFR mutation. Gu et al [ 18 ] pointed out that EGFR mutation rates in poor, moderate, well, and undefined differentiation were 17.8%, 35.8%, 50.0%, and 37.7%, respectively, showing no relevance ( p = 0.081). Some studies suggested EGFR gene mutation was associated with tumor differentiation.…”

Section: Pathological Featuresmentioning

confidence: 99%

Clinicopathologic Features and Molecular Biomarkers as Predictors of Epidermal Growth Factor Receptor Gene Mutation in Non-Small Cell Lung Cancer Patients

Liu

Xiong

2021

Current Oncology

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Lung cancer ranks first in the incidence and mortality of cancer in the world, of which more than 80% are non-small cell lung cancer (NSCLC). The majority of NSCLC patients are in stage IIIB~IV when they are admitted to hospital and have no opportunity for surgery. Compared with traditional chemotherapy, specific targeted therapy has a higher selectivity and fewer adverse reactions, providing a new treatment direction for advanced NSCLC patients. Tyrosine kinase inhibitors of epidermal growth factor receptor (EGFR-TKIs) are the widely used targeted therapy for NSCLC patients. Their efficacy and prognosis are closely related to the mutation status of the EGFR gene. Clinically, detecting EGFR gene mutation is often limited by difficulty obtaining tissue specimens, limited detecting technology, and economic conditions, so it is of great clinical significance to find indicators to predict EGFR gene mutation status. Clinicopathological characteristics, tumor markers, liquid biopsy, and other predictors are less invasive, economical, and easier to obtain. They can be monitored in real-time, which is supposed to predict EGFR mutation status and provide guidance for the accurate, individualized diagnosis and therapy of NSCLC patients. This article reviewed the correlation between the clinical indicators and EGFR gene mutation status in NSCLC patients.

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Value of combining serum carcinoembryonic antigen and PET/CT in predicting EGFR mutation in non-small cell lung cancer

Abstract: Gender, histology, pretreatment serum CEA level and SUVmax are significant predictors for mutations in NSCLC. Combining these factors in predicting mutations has a moderate diagnostic accuracy, and is helpful in guiding anti-tumor treatment.

Cited by 20 publications

References 33 publications

Carcinoembryonic antigen in pleural effusion of patients with lung adenocarcinoma: a predictive marker for EGFR mutation

Carcinoembryonic antigen in pleural effusion of patients with lung adenocarcinoma: a predictive marker for EGFR mutation

Value of combining PET/CT and clinicopathological features in predicting EGFR mutation in Lung Adenocarcinoma with Bone Metastasis

Clinicopathologic Features and Molecular Biomarkers as Predictors of Epidermal Growth Factor Receptor Gene Mutation in Non-Small Cell Lung Cancer Patients

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