Value of serum CEA and CA19-9 dynamic changes and trajectory modeling in prognosis assessment for non-small cell lung cancer.

OBJECTIVE

To investigate the value of dynamic changes and trajectory fitting of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in the prognosis of non-small cell lung cancer (NSCLC).

METHODS

A retrospective analysis was conducted on 244 NSCLC patients treated in our hospital from January 2019 to December 2022. CEA and CA19-9 levels were collected before treatment and at 14 days, 28 days, 3 months, and 6 months post-treatment. Latent class growth models were used to analyze the change trajectories of the CEA and CA19-9 levels. Independent prognostic factors affecting overall survival (OS) in patients with NSCLC were identified using Cox regression analysis. A Nomogram model was developed to predict survival rates, with the classification performance evaluated using calibration curves and the area under the time-dependent ROC curve (AUC).

RESULTS

Both CEA and CA19-9 trajectories in NSCLC patients were categorized into two distinct patterns: a continuously decreasing pattern and a decreasing-then-increasing pattern. The Results from the multivariate COX regression and nomogram indicated that advanced age, smoking, advanced TNM stage, squamous cell carcinoma, and decreased CEA or CA19-9 levels before reaching stable state were factors associated with reduced OS in patients with NSCLC. The AUC values of the ROC curves for the 1-, 2-, and 3-year survival rates in the training set were 0.733, 0.863, and 0.840, respectively. The AUC values for the test set were 0.769, 0.726, and 0.760, respectively.

CONCLUSION

Advanced age, smoking history, high TNM stage, squamous cell carcinoma, initial decrease followed by an increase in CEA, and initial decrease followed by an increase in CA19-9 are risk factors for reduced OS in patients with NSCLC. The clinical application of these factors enables the early identification of high-risk patients, facilitating early detection and intervention, and provides valuable data references for improving the prognosis of patients with NSCLC.