Prognostic significance of serum ca 125 antigen assay in patients with non-small cell lung cancer

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Abstract
Background. The serum levels of CA 125 tumor-associated antigen in patients with lung cancer have been previously related to TNM stage, histologic type, and survival rate. In the current study, the prognostic information provided by the CA 125 antigen assay was analyzed. Methods. Preoperative serum of CA 125 antigen was determined in 137 patients with non-small cell lung cancer. The assay was performed by means of a solidphase enzyme-immunoassay test. The influence of CA 125 serum level on postoperative outcome was studied by a multivariate analysis, performed with Cox's proportional hazards regression model. Results. Patients whose initial CA 125 level was higher than 15 U/ml had a 3.25-fold greater likelihood of relapse (95% confidence interval [CI], 1.7–6.21) (P < 0.001) and a 4.27-fold greater likelihood of death (95% CI, 2.42–7.55) (P < 0.001) due to cancer than patients with lower values. For patients with serum levels over 15 U/ml, the 36-month survival rate posttreatment was lower (67% versus 20%) (P < 0.001), as was the disease-free rate (64% versus 13%) (P < 0.001). After adjustment for TNM stages, histologic type, sex, and age, patients with CA 125 values over 15 U/ml continued exhibiting higher risk of relapse (hazard ratio, 2.2; 95% CI, 1.04–4.69) (P = 0.04) and higher risk of death (hazard ratio, 2.42; 95% CI, 1.29–4.54) (P = 0.006). Conclusions. CA 125 is an independent prognostic factor of survival and tumor relapse in non-small cell lung cancer. The preoperative serum level of CA 125 antigen is inversely correlated with the outcome figures. The authors suggest that CA 125 be included in any future multifactorial analysis of survival. Cancer 1994; 73:1368–76.