Clinicopathological Features And Prognostic Analysis In Patients With Non-small Cell Lung Cancer With CA19-9 Elevation

Objectives To analyze the clinical and pathological features of patients with non-small cell lung cancer(NSCLC)accompanied by CA19-9 elevation,and to explore the prognostic value of CA19-9 elevation in NSCLC patients.Methods The clinical data and tumor markers of 189 patients with NSCLC who were treated in Tangshan Gongren Hospital from January 1,2017 to August 1,2020 were retrospectively analyzed.With unit serum content 34U/m L as the critical value,patients were divided into two groups:elevated CA19-9 group and normal CA19-9 group.The differences in pathological types,clinical stages,Viscera metastasis,gene mutation(include EGFR,KRAS,ALK,ROS1),Immune checkpoint(PD-L1)expression and overall survival were compared between the two groups.SPSS17.0 was used for statistical processing and analysis of the data.The test level wasα=0.05.And P<0.05 was considered statistically significant.Results Among 189 patients,55 patients had increased CA19-9,and the proportion of total abnormal increase was 29.10%.The proportion of adenocarcinoma and non-adenocarcinoma patients in the elevated CA19-9 group was 87.27%(48/55)and 12.73%(7/55),respectively.And 76.36%(42/55)were in clinicalⅣstage patients.The patients with early stage(Ⅰ-Ⅲ)accounted for 23.64%.Of the stageⅣpatients,33.33%(14/42)had liver metastasis,61.90%(26/42)had bone metastasis,and 45.24%(19/42)had intrapulmonary metastasis.The incidence of brain metastasis,adrenal metastasis and pleural effusion was 33.33%(14/42),14.29%(6/42)and 21.43%(9/42).Among normal patients with CA19-9,15.22%(7/46)had liver metastasis,56.52%(26/46)had bone metastasis,30.43%(14/46)had intrapulmonary metastasis.The proportion of patients with brain metastasis,adrenal metastasis and pleural effusion were 32.61%(15/46),8.70%(4/46)and 8.70%(4/46),respectively.According to statistics,the frequency of liver metastasis in the group with increased CA19-9 was significantly higher than that in the normal group(χ~2=3.96,P<0.05).CA19-9 levels were not associated with other organ metastases(P>0.05).Among the patients with adenocarcinoma,40.00%(44/110)had positive EGFR mutation,and 18.52%(5/27)of the patients had KRAS mutations.There was no statistically significant difference in EGFR,KRAS,ALK,ROS1 mutation between the two groups(P>0.05).The elevation of CA19-9 was not related to the expression of PD-L1(P>0.05).CA19-9 levels is an independent prognostic risk factor in patients with NSCLC.Conclusions The increase of CA19-9 is mainly seen in patients with lung adenocarcinoma.Elevated CA19-9 levels predict later stage,more extensive lesions and poorer prognosis.In this study,no significant relationship was found between elevated CA19-9 and common gene mutations such as EGFR,ALK and KRAS,which still needs further discussion.Figure0;Table7;Reference 210...