Clinical Significance Of Dynamic Variation Of Tumor Markers On Therapeutic Effect Evaluation In Advanced Lung Cancer Patients

AimTo investigate the relationship between the variation of differentTumor Markers (TMs) before and after chemotherapy from each courseand the imaging evaluation, as well as the relationship between TMs andprogress free survival (PFS) in the advanced stage of lung cancer (LC)patients.Materials and Methods1，Seventy-three cases of advanced stage LCs were recruited fromthe First Affiliated Hospital, Guangxi Medical University, from January2008to December2013, which had been confirmed by pathologyexamination. ELISA was performed to detect the levels of various of TMsin the sera, including Carcino-embryonic antigen (CEA)，Carbohydrateantigen (CA125) and Serum ferritin (SF) according to different timepoints: before first chemotherapy and after the2nd,4th,6thcycle. Allclinicopathological parameters were also collected. Survival time wasfollowed up via telephone. The software SPSS20.0was used for statistics.A2-tailed P value≤0.05was considered statistically significant. Results1，The variation ratios of CEA and CA125of each cycle, as well asthe variation ratios of SF after the4thcycles were significantly correlatedwith the corresponding imaging evaluation (all P<0.05). The variationstatuses of CEA of each cycle, as well as the variation statuses of SF afterthe4thand6thcycles, CA125after the2ndand6thcycles weresignificantly correlated with the corresponding imaging evaluation (allP<0.05).2，The areas under the ROC curve (AUCs) were0.682,0.693and0.806for CEA after each cycle, respectively. The AUCs were0.793and0.757for SF after the4thand6thcycles, showing good predictivevalue of therapeutic effect.3，The PFS was11.80mon in the group of ECOG PS <2for thebaseline level, significantly longer than that in the group of ECOG PS=2(9.2mon, P=0.019). The PFS was10.5mon in the group of CEAdecreasing, significantly longer than that in the group of CEA stabilizingand increasing (both8.3mon, P=0.025).4，Multivariate Cox Regression analysis suggested that ECOG PSwas the only independent prognostic factor. Furthermore, ECOG PS<2was a protective factor.Conclusion1, The variation of the sera TMs (CEA, SF and CA125) plays animportant role in predicting the therapeutic effect of LC patients inadvanced stage.2, In general, poor efficiency is found when estimating the effect ofimaging evaluation by sera TMs. The decreasing ratio of CEA in each cycle has sub-optimal judging power for the objective therapeutic effectevaluation. However, SF achieves stronger judging influence in the4thand6thcycle.3The status of baseline ECOG PS and variation of CEA are closelyrelated to PFS of LC patients. However, variation of CEA is not anindependent prognostic factor for LC patients.