The relationship between CEA levels and survival rate in lung adenocarcinoma patients with Egfr mutations and wild type

Abstract

Author(s): Andi Paramita Yasir*, Erna Kusumawardhani, Mohammad Rudiansyah, Ira Nurrasyidah, Ali Assagaf, Isa Ansori

Background: Carcinoembryonic Antigen (CEA), typically present at elevated levels in lung adenocarcinoma, may serve as a prognostic biomarker. However, its relationship with outcomes across Epidermal Growth Factor Receptor (EGFR) molecular subtypes remains uncertain. This study evaluated post-therapy CEA in relation to survival and compared concentrations between the variant and wildtype groups.
Method: This retrospective cohort included 50 individuals treated for lung adenocarcinoma at Ulin General Hospital, Banjarmasin, from January 2023 to December 2024. There were 31 variant-positive cases received tyrosine kinase inhibitors, whereas 19 wild-type cases received chemotherapy. CEA was classified as ≤10 or >10 ng/mL. Kaplan-Meier curves and the log-rank test assessed survival, and Cox regression examined relevant associations; p<0.05 indicated statistical significance.
Result: Elevated CEA (>10 ng/mL) occurred in 58% of the cohort, and 62% carried an EGFR variant. Median concentrations were 43.3 ng/mL in the variant group versus 4.3 ng/mL in the wild-type group (p=0.012). Six-month survival for the ≤10 and >10 ng/mL categories was 100% and 82.6%, respectively, among variant carriers (p=0.221), and 92.3% and 83.3% among wild-type cases (p=0.596). Multivariable analysis found no significant relationship between biomarker concentration and outcome in either molecular group (p=0.338 and p=0.942, respectively); age >60 years independently predicted mortality (p=0.029).
Conclusion: Post-therapy CEA did not correlate significantly with survival in either molecular subgroup. Nevertheless, concentrations were higher in variant-positive than in wild-type cases at Ulin Hospital, Banjarmasin, Indonesia

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