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CEA may be used to indicate that a medianoscopy should be performed, though this is only one study



The significance of tumour markers as an indication for mediastinoscopy in non-small cell lung cancer.

Ando S, Kimura H, Iwai N, Kakizawa K, Shima M, Ando M.

Division of Thoracic Diseases, Chiba Cancer Center, Departments of Chest Medicine and Public Health, Chiba University School of Medicine, Chiba, Japan.

OBJECTIVE: The purpose of this study was to verify the significance of tumour markers as indicators for mediastinoscopy in non-small cell lung cancer. METHODOLOGY: In the past 4 years, 205 patients with non-small cell lung carcinoma (NSCLC) underwent surgical resection at Chiba Cancer Center, Chiba, Japan. The correlation between the serum levels of eight tumour markers (CEA, AFP, CA19-9, SCC, NSE, CA125, CYFRA, ProGRP) and the presence of N2 disease was analysed. Univariate and multivariate analyses were performed to determine the relationship between both marker levels and clinical findings and N2 disease. RESULTS: In multivariate analysis, positive CEA was significantly associated with the diagnosis of N2 disease. We also demonstrated that when CA125, CYFRA and ProGRP were positive, they were individually significantly associated with N2 disease. However, CEA was superior to the other markers and equivalent to a combination of various tumour markers. CONCLUSION: It was concluded that evaluation of CEA in addition to CT is of use in the diagnosis of N2 disease in NSCLC patients and should be used as an indication for mediastinoscopy.

PMID: 12753530 [PubMed - in process]

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Thanks lynn. I dont always understand 100% of the stuff I find (could be dangerous), but hopefully it may open up some topics to discuss with each persons doctor(s)

One of the biggest problems seems to be staging. I know with my mom she was stage I clinically. Then stage IIIa pathologically before the lobectomy. If she was staged at IIIa, before she was opened up then induction (neoadjuncvtive) chemotherapy could have been done. This is supposed to be the best treatment. I have read that many people on this board have had this unfortunate experience

take care

Identifying patients at risk of early postoperative recurrence of lung cancer: a new use of the old CEA test.

Buccheri G, Ferrigno D.

Cuneo Lung Cancer Study Group, Divisione di Pneumologia, Ospedale S. Croce e Carle, Cuneo, Italy. buccheri@culcasg.org

BACKGROUND: In the current study, we report the carcinoembryonic antigen (CEA) capability to predict early tumor relapses after a pulmonary resection for nonsmall cell lung cancer (NSCLC). METHODS: We studied 118 consecutive NSCLC patients who were clinically judged operable and were eventually operated upon. Anthropometric, clinical, and CEA data along with the results of both preoperative and postoperative stage classifications were recorded. All patients were followed up for at least 1 year after surgery and the time to the first clinical recurrence recorded. Receiver-operating characteristic (ROC) curves and diagnostic formulas were used for data analysis. RESULTS: In this series the CEA test was among the most accurate methods to predict an early postoperative recurrence (ROC area: 0.72, 95% confidence interval [CI]: 0.60 to 0.85, p = 0.001; accuracy rate for CEA at the threshold of 10 ng/mL: 83%, CI: 76% to 90%). Also predictive was the postoperative pathologic stage of disease (ROC area: 0.68, CI: 0.56 to 0.80, p = 0.007). In tumors pathologically classified in stage Ia to IIb, a preoperative CEA level higher than 10 ng/mL was associated with a 67% probability of tumor relapse. In the same stages of disease, a CEA level less than 10 ng/mL increased the baseline probability of no recurrence from 80% to 88%. CONCLUSIONS: In operable patients with NSCLC the frequency of abnormal serum concentrations of CEA is low (17% in our series). However, it is important to identify such a small group of high-risk patients as many of them (in our study, 55% and 70% of those with a CEA value in excess of, respectively, 5 and 10 ng/mL) will develop an early postoperative recurrence. Such patients should be investigated preoperatively by mediastinoscopy or positron emission tomography in even in the absence of suspicious symptoms and signs. Then after an apparently successful operation, they should be carefully followed up. These patients could represent a suitable target for neoadjuvant clinical trials of selected high-risk groups.

PMID: 12645726 [PubMed - indexed for MEDLINE]

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Thanks John,

Have also read the above, my onc. plots my CEA readings every 3 months, although because they are rising ( 2.5 to 7 and the last @ 13 ) we are now checking every 8 weeks. However, important to note is that CEA levels can also rise due to lung infections ( bronchitis etc. ) , bowel disorders - IBS, and a few other disorders that I can't remember.

I go next week for additional blood work, thanks again for the inf.

God bless and be well

Bobmc - NSCLC - stage IIB - left pneumonectomy - 5/2/01

" absolutely insist on enjoying life today!"

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