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. 2018 Apr 24:2018:2942618.
doi: 10.1155/2018/2942618. eCollection 2018.

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

Wang-Yu Zhu  1   2   3 , Hai-Feng Li  4 , Ke-Xin Fang  1 , Bing-Jie Zhang  2   3 , Shi-Quan Zhou  1 , Yong-Kui Zhang  2   3 , Han-Bo Le  2   3 , Xiao-Fei Hu  2
Affiliations

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

Wang-Yu Zhu et al. Dis Markers. .

Abstract

Aims: The prognostic value of epidermal growth factor receptor (EGFR) mutations in the context of serum carcinoembryonic antigen levels remains controversial in T1 lung adenocarcinoma.

Methods: Clinical and pathological characteristics, preoperational carcinoembryonic antigen levels, EGFR mutations, and disease-free and overall survival were analysed retrospectively in 573 pathological T1 patients in East China.

Results: EGFR mutations were detected in 220 of 573 patients (38.4%). Patients with serum carcinoembryonic antigen levels ≥ 2.12 ng/mL had worse disease-free (P < 0.001) and overall survival (P < 0.001) than had others, although survival was comparable between patients with and without EGFR mutations. However, patients with exon 21 mutations in EGFR had significantly better overall survival than had patients with exon 19 mutations (P = 0.016), although disease-free survival was comparable (P = 0.424). Among patients with serum carcinoembryonic antigen levels ≥ 2.12 ng/mL, disease-free (P = 0.019) and overall survival (P < 0.001) was also better than that in those with exon 21 mutations. Finally, the exon 19 deletion was found to be an independent predictor of unfavourable overall survival (P = 0.037).

Conclusions: EGFR mutations were associated with preoperational serum carcinoembryonic antigen levels ≥ 2.12 ng/mL. In patients with levels above this threshold, those with the exon 19 deletion have less favourable prognosis than have those with the exon 21 mutation.

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Figures

Figure 1
Figure 1
Box and whisker plot of preoperational CEA levels between EGFR mutated (n = 220) and wild-type (n = 353) lung carcinoma patients [1.83 (1.22, 2.91) versus 1.61 (1.05, 2.54), P = 0.0209].
Figure 2
Figure 2
Kaplan-Meier curves after surgery in 573 lung adenocarcinoma patients with tumours with a maximum diameter of 3 cm or less. (a) Disease-free and (b) overall survival stratified by presence and absence of EGFR mutations. (c) Disease-free and (d) overall survival stratified by EGFR mutations in exon 19 and exon 21.
Figure 3
Figure 3
Kaplan-Meier curves after surgery in lung adenocarcinoma patients with tumours with a maximum diameter of 3 cm or less. (a) Disease-free and (b) overall survival stratified by preoperational serum carcinoembryonic antigen levels with a cut-off of 2.12 ng/mL. (c) Disease-free and (d) overall survival in patients with carcinoembryonic antigen levels below 2.12 ng/mL and stratified by mutations in exon 19 and 21. (e) Disease-free and (f) overall survival in patients with carcinoembryonic antigen levels above 2.12 ng/mL and stratified by mutations in exon 19 and 21.
Figure 4
Figure 4
Kaplan-Meier curves after surgery in 403 lung adenocarcinoma patients with tumours with a maximum diameter of 3 cm or less, excluding those at stage 0. (a) Disease-free and (b) overall survival stratified by presence and absence of EGFR mutations. (c) Disease-free and (d) overall survival stratified by EGFR mutations in exon 19 and exon 21.
Figure 5
Figure 5
Kaplan-Meier curves after surgery in lung adenocarcinoma patients with tumours with a maximum diameter of 3 cm or less, excluding those at stage 0. (a) Disease-free and (b) overall survival stratified by preoperational serum carcinoembryonic antigen levels with a cut-off of 2.12 ng/mL. (c) Disease-free and (d) overall survival in patients with carcinoembryonic antigen levels below 2.12 ng/mL and stratified by mutations in exon 19 and 21. (e) Disease-free and (f) overall survival in patients with carcinoembryonic antigen levels above 2.12 ng/mL and stratified by mutations in exon 19 and 21.
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