The Indicative Value of Serum Tumor Markers for Metastasis and Stage of Non-Small Cell Lung Cancer
by
Chunyang Jiang
1,2,3,†, 
Mengyao Zhao
4,†,
Shaohui Hou
3,
Xiaoli Hu
5,
Jinchao Huang
6,
Hongci Wang
7,
Changhao Ren
8,
Xiaoying Pan
8,
Ti Zhang
8,
Shengnan Wu
8,
Shun Zhang
4,* and
Bingsheng Sun
9,10,* 1
Department of Thoracic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
2
Department of Thoracic Surgery, The First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China
3
Department of Thoracic Surgery, Tianjin Union Medical Center, Nankai University, Tianjin 300121, China
4
Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
5
Department of Respiratory, The Second People’s Hospital of Linhai City, Linhai 317000, China
6
Department of Cancer Prevention, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300181, China
7
Baodi District People’s Hospital of Tianjin, Tianjin Baodi Hospital of Tianjin Medical University, Tianjin 301000, China
8
Medical College, Nankai University, Tianjin 300071, China
9
Department of Thoracic Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300181, China
10
National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300181, China
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Cancers 2022, 14(20), 5064; https://doi.org/10.3390/cancers14205064
Submission received: 27 September 2022
/
Revised: 11 October 2022
/
Accepted: 13 October 2022
/
Published: 16 October 2022
(This article belongs to the Special Issue Biomarkers of Tumor Metastasis and Invasiveness)
Simple Summary
This study recruited 3272 non-small cell lung cancer (NSCLC) cases to analyze the predictive abilities of serum tumor markers (CEA, SCC-Ag, CYFRA 21-1, NSE, ProGRP, TPSA and CA199) for metastasis and clinical stage, and found that tumor marker levels may be indicative of tumor metastasis (intrapulmonary, lymphatic and distant metastasis) and stage. Increased CEA and CA199 provided an accurate prediction of intrapulmonary and distant metastasis. Increased CEA, CYFRA 21-1 and CA199 provided an accurate prediction of lymphatic metastasis and higher tumor stage. Combined detection of serum tumor markers can indicate tumor metastasis and stage in NSCLC patients.
Abstract
Objective: This study aimed to explore the roles of serum tumor markers for metastasis and stage of non-small cell lung cancer (NSCLC). Methods: This study recruited 3272 NSCLC patients admitted to the Tianjin Union Medical Center and the Tianjin Medical University Cancer Institute and Hospital. The predictive abilities of some serum tumor markers (carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), cytokeratin-19 fragment (CYFRA 21-1), neuron-specific enolase (NSE), pro-gastrin-releasing peptide (ProGRP), total prostate-specific antigen (TPSA) and carbohydrate antigen 199 (CA199)) for NSCLC metastasis (intrapulmonary, lymphatic and distant metastasis) and clinical stage were analyzed. Results: Tumor markers exhibited different numerical and proportional distributions in NSCLC patients. Elevated CEA, CYFRA 21-1 and CA199 levels were indicative of tumor metastasis and stage. Increased CEA and CA199 provided an accurate prediction of intrapulmonary and distant metastasis with the area under the receiver operator characteristic curve (AUC) of 0.69 both (p < 0.001); Increased CEA, CYFRA 21-1 and CA199 provided an accurate prediction of lymphatic metastasis with the AUC of 0.62 (p < 0.001). Conclusion: Combined detection of serum tumor markers can indicate tumor metastasis and stage in NSCLC patients.
