Epidermal Growth Factor Receptor Mutations and Their Prognostic Value with Carcinoembryonic Antigen in Pathological T1 Lung Adenocarcinoma

Clinical impact of pleural fluid carcinoembryonic antigen on therapeutic strategy and efficacy in lung adenocarcinoma patients with malignant pleural effusion

BACKGROUND/AIMS

Epidermal growth factor receptor (EGFR) mutation is important in determining the treatment strategy for advanced lung cancer patients with malignant pleural effusion (MPE). Contrary to serum carcinoembryonic antigen (S-CEA) levels, the associations between pleural fluid CEA (PF-CEA) levels and EGFR mutation status as well as between PF-CEA levels and treatment efficacy have rarely been investigated in lung adenocarcinoma patients with MPE.

METHODS

This retrospective study enrolled lung adenocarcinoma patients with MPE and available PF-CEA levels and EGFR mutation results. The patients were categorized based on PF-CEA levels: < 10 ng/mL, 10-100 ng/mL, 100-500 ng/mL, and ≥ 500 ng/mL. The association between PF-CEA levels and EGFR mutation status as well as their therapeutic impact on overall survival was compared among the four groups.

RESULTS

This study included 188 patients. PF-CEA level was found to be an independent predictor of EGFR mutation but not S-CEA level. The EGFR mutation rates were higher as the PF-CEA levels increased, regardless of cytology results or sample types. Among EGFR-mutant lung adenocarcinoma patients receiving EGFR-tyrosine kinase inhibitor (TKI) treatment, those with high PF-CEA levels had significantly better survival outcomes than those with low PF-CEA levels.

CONCLUSION

High PF-CEA levels were associated with high EGFR mutation rate and may lead to a favorable clinical outcome of EGFR-TKI treatment in EGFR-mutant lung adenocarcinoma patients with MPE. These findings highlight the importance of actively investigating EGFR mutation detection in patients with suspected MPE and elevated PF-CEA levels despite negative cytology results.

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

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.

Guanylate-binding protein 1 correlates with advanced tumor features, and serves as a prognostic biomarker for worse survival in lung adenocarcinoma patients

OBJECTIVE

Guanylate-binding protein 1 (GBP1) is reported to promote tumor progression and treatment resistance in lung cancer, and presents as a prognostic biomarker in several solid tumors. However, the related research of GBP1 in clinical management of lung adenocarcinoma is still lacking. Therefore, the present study aimed to detect the clinical role of GBP1 in lung adenocarcinoma.

METHODS

The clinical data of 221 lung adenocarcinoma patients were retrospectively analyzed, and then, their tumor tissue specimens and paired adjacent tissue specimens were retrieved for GBP1 detection via immunohistochemistry (IHC) assay.

RESULTS

GBP1 expression was upregulated in tumor tissues compared with adjacent tissues (P < .001). Moreover, high tumor GBP1 expression was associated with larger tumor size (P = .030), positive lymph node (LYN) metastasis (P = .001), advanced TNM stage (P = .001), and abnormal preoperative carcinoembryonic antigen (CEA) level (P = .026). Furthermore, tumor GBP1 high expression was correlated with reduced disease-free survival (DFS) and overall survival (OS), and was of independent value in predicting worse DFS and OS. Additionally, data analysis of 1144 lung cancer patients derived from KMplot database (www.kmplot.com) further verified that GBP1 expression was negatively correlated with OS (P = .009).

CONCLUSION

GBP1 correlates with advanced tumor features and worse survival profiles, suggesting its value to be a prognostic biomarker in management of lung adenocarcinoma.