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Vol.48 No.1 contents

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- Original Article -

The Significance of Changes in Serum CEA Level as a Surrogate Marker for Evaluating Tumor Response to Chemotherapy in Non-small Cell Lung Cancer

Futoshi Ishiguro¹, Shoichi Mori¹, Tatsuya Katayama¹, Katsuhiro Okuda¹, Noriaki Sakakura¹, Takayuki Fukui¹, Shunzo Hatooka¹, Masayuki Shinoda¹, Tetsuya Mitsudomi^1
1Department of Thoracic Surgery, Aichi Cancer Center Hospital, Japan

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Objectives. The aim of this study was to evaluate changes in serum carcinoembryonic antigen (CEA) level as a surrogate marker for tumor response. Patients and Methods. During an 11-year period from 1995 through 2005, 24 non-small cell lung cancer (NSCLC) patients with high serum CEA level (>5 ng/ml) at presentation, who received chemotherapy followed by surgery were retrospectively analyzed. We compared changes in serum CEA level with response evaluation criteria in solid tumors (RECIST), WHO criteria or histologic response for evaluating tumor response to chemotherapy in NSCLC. Result. When we compared serum CEA level before chemotherapy with that obtained after chemotherapy, it significantly decreased in partial response (PR) group defined by RECIST or WHO criteria [P=0.004, P=0.008, respectively]. On the contrary, in patients whose responses were either stable disease (SD) or no change (NC), there was no significant difference. CEA level decreased significantly in patients in whom less than one-third of tumor cells were viable [P=0.008] but not in whom more than two-thirds of tumor cells were viable. From the receiver-operating characteristic curve analysis, 60% reduction of CEA level was an appropriate cut-off value in predicting good response to the chemotherapy. When set at that level, the sensitivity of CEA for RECIST was 82% and the specificity was 69%. Conclusion. Determination of changes in serum CEA level appeared to be useful as a surrogate index for evaluation of tumor response to chemotherapy that would result in comparable judgment with RECIST in patients with NSCLC who had elevated CEA level before treatment.
key words: Evaluation of tumor response, Carcinoembryonic antigen (CEA), Response evaluation criteria in solid tumors (RECIST)

Received: August 9, 2007
Accepted: November 17, 2007

JJLC 48 (1): 26-32, 2008