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J Thorac Cardiovasc Surg 1998;116:412-416
© 1998 Mosby, Inc.

General Thoracic Surgery

Serum carcinoembryonic antigen as an adjunct to preoperative stagingof lung cancer

Supported by the Veterans Affairs Department of Research.

Received for publication Nov. 24, 1997. Revisions requested Jan. 30, 1998; revisions received May 14, 1998. Accepted for publication June 3, 1998. Address for reprints: Jeffrey B. Rubins, MD, Pulmonary (111N), VAMedical Center, One Veterans Dr, Minneapolis, MN 55417.

Objective: To determine whethermeasurement of preoperative serum carcinoembryonic antigen concentrations addsuseful prognostic data to current preoperative staging of lung cancer bycomputed tomography, bronchoscopy, and mediastinoscopy.
Methods: A prospective cohort study of 130 consecutivepatients was evaluated for suspected lung cancer from July 1991 through December1992 at a university-affiliated Veterans Affairs Medical Center. Serumconcentrations of carcinoembryonic antigen were measured before diagnosis,staging, or resection of cancer.
Results:Malignant disease was diagnosed by bronchoscopy, needle biopsy, mediastinoscopy,or resection in 111 of 130 patients. In the 50 patients undergoing resectionwith curative intent, multivariate analysis indicated that carcinoembryonicantigen was a significant predictor of survival independent of patient age,pathologic stage, histologic type, and tumor size (P =.0357).
Conclusions: Elevated preoperativeserum concentrations of carcinoembryonic antigen predict a poor prognosis forlung cancer independent of other conventional staging parameters and have anadjunctive role in the staging of lung cancer. (J Thorac Cardiovasc Surg1998;116:412-6)

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