Background: Lung adenocarcinoma in Taiwan has unique characteristics, such as a high EGFR mutation rate. While CEAs are a commonly used serum tumor marker (STM), the prognostic value of CA-125, CA-153, and CA-199 remains unclear. This study evaluates their clinical utility in predicting disease progression and prognosis. Methods: A multicenter retrospective study of 1133 patients with lung adenocarcinoma from three hospitals in Taiwan was conducted (2014–2021). Clinical data and STM levels (CEA, CA-125, CA-153, CA-199) were collected. Cox proportional hazards models were used to identify independent predictors of disease-free survival (DFS) and progression-free survival (PFS). Results: CEA, CA-125, CA-153, and CA-199 levels increased with lung adenocarcinoma stage (p< 0.001). In the early stages, CEA was an independent predictor of DFS (HR = 2.58,p< 0.001). In stage IV patients, CA-125 and CA-199 predicted poor PFS (CA-125: HR = 1.17,p= 0.004; CA-199: HR = 1.09,p= 0.049). Among those treated with EGFR tyrosine kinase inhibitors (TKIs), CA-125 remained a significant predictor (HR = 1.33,p< 0.001). Conclusions: CA-125 and CA-199 may be superior to CEAs in predicting poor PFS in stage IV lung adenocarcinoma, especially for EGFR TKI-treated patients. These easily accessible markers could aid prognosis and treatment decisions, although further validation is required.
背景：台湾地区的肺腺癌具有独特特征，如较高的EGFR突变率。虽然癌胚抗原（CEA）是常用的血清肿瘤标志物（STM），但CA-125、CA-153和CA-199的预后价值尚不明确。本研究旨在评估这些标志物在预测疾病进展和预后方面的临床效用。方法：对台湾三家医院2014年至2021年间的1133例肺腺癌患者进行多中心回顾性研究。收集临床资料及血清肿瘤标志物（CEA、CA-125、CA-153、CA-199）水平。采用Cox比例风险模型确定无病生存期（DFS）和无进展生存期（PFS）的独立预测因子。结果：CEA、CA-125、CA-153和CA-199水平随肺腺癌分期升高而增加（p<0.001）。在早期阶段，CEA是DFS的独立预测因子（HR=2.58，p<0.001）。在IV期患者中，CA-125和CA-199可预测不良PFS（CA-125：HR=1.17，p=0.004；CA-199：HR=1.09，p=0.049）。在接受EGFR酪氨酸激酶抑制剂（TKI）治疗的患者中，CA-125仍是显著预测因子（HR=1.33，p<0.001）。结论：在预测IV期肺腺癌不良PFS方面，CA-125和CA-199可能优于CEA，尤其对于EGFR TKI治疗的患者。这些易于获取的标志物有助于预后评估和治疗决策，但尚需进一步验证。
肿瘤(癌症)患者之家