The Prognostic and Predictive Value of Pretreatment Serum Tumor Markers in Lung Adenocarcinoma with Different EGFR Status

Background: The prognostic value of carcinoembryonic antigen (CEA), cytokeratin-19 fragments (Cyfra21-1), neuron-specific enolase (NSE), Glycogen Antigen 153, Glycogen Antigen 199 has been investigated in Lung Adenocarcinoma (LUAD). However, few studies have directly focused on the association between serum tumor markers and epidermal growth factor receptor (EGFR) mutation status.Material and Method: 146 patients with stage IIIB and IV LUAD were enrolled between 2008 and 2018. Correlations between serum tumor marker levels, EGFR mutations and survival were analyzed and prognostic factors were identified.Result: Of eligible 90 patients with EGFR-mutant LUAD, CA 15-3 (7 versus 9 months, 0.037 for PFS; 25 months versus 36 month, P = 0.003 for OS, ) and Cyfra21-1 (7.0 versus 9.0 months, P =0.010 for PFS, 25 months versus 36 months, P=0.044 for OS,showed negatively significant correlation with overall survival and Progression free survival. For parents without EGFR-mutation, CA125 (month versus 8 months, P = 0.013 for DFS, 18 months versus 24 month, P = 0.016 for OS) also showed negatively significant correlation with overall survival and Progression free survival.Conclusion: CA153 and Cyfra21-1 was a prognostic serum biomarker in EGFR-mutant LUAD patient, coincide with CA125 in EGFR-WT LUAD group.Cyfra21-1 levels was also a predictive serum biomarker for in EGFR-mutant LUAD patient who received EGFR-TKI treatment.