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Yang Y, Xu M, Huang H, Jiang X, Gong K, Liu Y, Kuang X, Yang X. Serum carcinoembryonic antigen elevation in benign lung diseases. Sci Rep 2021; 11:19044. [PMID: 34561515 PMCID: PMC8463604 DOI: 10.1038/s41598-021-98513-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/03/2021] [Indexed: 02/07/2023] Open
Abstract
Carcinoembryonic antigen (CEA) is not only used to aid the diagnosis of lung cancer, but also help monitor recurrence and determine the prognosis of lung cancer as well as evaluate the therapeutic efficacy for lung cancer. However, studies have also shown that CEA is present at low levels in the serum of patients with benign lung diseases (BLD), which will interfere with the accurate judgment of the disease. Due to difference in sample size, detection methods, cutoff values and sources of BLD, the positive rate of CEA in BLD is different with different literature. Therefore, it is necessary to define CEA levels in patients of different BLD in a large sample study. 4796 patients with BLD were included in this study. The results showed that the CEA levels of 3.1% (149/4796) patients with BLD were elevated, with three cases exceeds 20 ng/mL (0.06%, 3/4796). The results from the literature showed that BLD had a mean positive rate of 5.99% (53/885) and only two cases had CEA above 20 ng/mL. The CEA elevations mainly distributed in chronic obstructive pulmonary disease (COPD), pneumonitis and interstitial lung disease and significantly correlated with age of patients (OR 2.69, 95% CI 1.94–3.73, p < 0.001). Pulmonary tuberculosis (7/1311, 0.53%) had the lowest positive rate of CEA elevations while pulmonary alveolar proteinosis (6/27, 22.22%) had the highest positive rate. The majority of patients with abnormally elevated CEA levels had multiple underlying diseases, mainly diseases of the circulatory system (42.28% [63/149]), endocrine diseases (26.85% [40/149]), and respiratory or heart failure (24.16% [36/149]. In endocrine diseases, 87.5% (35/40) of patients had diabetes. In conclusion, CEA is present at a low positive rate in the serum of patients with BLD, but few exceed 20 ng/mL. For lung disease patients, if CEA levels rise, we should carry out comprehensive analysis of types of lung diseases, age of patients, and comorbid diseases.
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Affiliation(s)
- Yi Yang
- Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China
| | - Mingfang Xu
- Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China
| | - Huan Huang
- Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China
| | - Xiaolin Jiang
- Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China
| | - Kan Gong
- Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China
| | - Yun Liu
- Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China
| | - Xunjie Kuang
- Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China
| | - Xueqin Yang
- Cancer Department, Daping Hospital, Army Medical University, No. 10 Changjiang Zhi Road, Daping Yuzhong District, Chongqing, 400042, China.
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Okabe R, Chen-Yoshikawa TF, Yoshizawa A, Nakajima N, Saito M, Hamaji M, Date H. Association Between Pretransplant Serum Carcinoembryonic Antigen Levels and Immunohistochemical Staining of Explanted Native Lungs in Patients Who Underwent Lung Transplantation. Semin Thorac Cardiovasc Surg 2020; 33:608-615. [PMID: 32977009 DOI: 10.1053/j.semtcvs.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 09/08/2020] [Indexed: 11/11/2022]
Abstract
Some patients show high serum carcinoembryonic antigen (CEA) levels in the evaluation of candidate patients for lung transplantation, which might be a challenge because high serum CEA potentially implies an existence of malignancy. For further understanding of the true meaning of high serum CEA levels in lung transplantation, we retrospectively investigated the relationship between serum CEA and clinical data. We also performed immunohistochemical analysis of explanted native lungs and evaluated its relationship with serum CEA levels. Retrospective chart review was performed in consecutive patients who underwent lung transplantation with measurement of serum CEA before and after transplantation at our institution between August 2008 and June 2017. Histopathological analysis was also performed in the same cohort of patients. Survival outcomes and pathohistological findings were compared between the high serum CEA and the normal CEA group, adjusting for potential confounding factors. One hundred and fifteen patients were eligible for analysis. High serum CEA levels before lung transplantation in most cases were decreased after the transplantation (35/39, 90%, P < 0.001). Preoperative serum CEA levels were not associated with postoperative survival. The percentage of CEA-positive alveolar cells was significantly higher in the high serum CEA group (P < 0.0001). After adjusting for potential confounding factors, there was a significant difference between the high serum CEA group and normal serum CEA group (CEA-positive alveolar cells; P = 0.002). High serum CEA levels before lung transplantation might derive from native lungs in the recipients and that they were not associated with overall survival after lung transplantation.
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Affiliation(s)
- Ryo Okabe
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Toyofumi F Chen-Yoshikawa
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan; Department of Thoracic Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Akihiko Yoshizawa
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Naoki Nakajima
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Masao Saito
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Masatsugu Hamaji
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan.
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Nomoto H, Miyoshi H, Sekizaki T, Atsumi T. Comment on "Elevation of Serum Carcinoembryonic Antigen Concentration Caused by Everolimus-Induced Lung Injury: A Case Report". Ann Thorac Cardiovasc Surg 2018; 24:165-166. [PMID: 29553086 PMCID: PMC6033523 DOI: 10.5761/atcs.lte.18-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hiroshi Nomoto
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideaki Miyoshi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tomonori Sekizaki
- Department of Diabetes and Lipid Metabolism Internal Medicine, Hokkaido Medical Center, Sapporo, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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