ORIGINAL RESEARCH article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1627122
This article is part of the Research TopicAdvancing Non-small Lung Cancer Management Through Biomarker IntegrationView all 5 articles
Trajectories of Perioperative Serum CEA and Non-Small Cell Lung Cancer Prognosis: A Retrospective Longitudinal Cohort Study
Provisionally accepted
Yuyang Ma
Xiaoyin PanJiameng CuiWanzhu LuGege SunJunlong PanDong Xiao
Kejia Hu
Wenyuan Li
Huakang Tu*
Xifeng Wu*- Zhejiang University, Hangzhou, China
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Background: The role of postoperative carcinoembryonic antigen (CEA) levels in non-small lung cancer (NSCLC) prognostic evaluation remains unclear. Additionally, the dynamic changes in CEA levels during the perioperative period have not been fully characterized. Methods: We retrospectively reviewed stage I-IIIA NSCLC patients who underwent curative resection. A latent class growth mixed model was employed to categorize patients into distinct CEA trajectory groups. The Kaplan-Meier method assessed the relationship between CEA trajectory groups and recurrence-free survival (RFS) and overall survival (OS). Multivariate analysis of perioperative CEA levels in relation to RFS and overall survival OS was performed using Cox proportional hazards regression. Results: A total of 5733 patients were included in our study. Elevated postoperative CEA levels were associated with higher risks of recurrence (HR = 2.64, 95% CI: 1.65-4.23) and mortality (HR = 3.34, 95% CI: 2.09-5.80) compared to normal CEA levels. Furthermore, patients with normal preoperative CEA but elevated postoperative levels also had higher risks of recurrence (HR = 3.00, 95% CI: 1.77–5.10) and mortality (HR = 3.30, 95% CI: 1.79–6.07). Three CEA trajectory categories were identified: low-stable, early-rising, and later-rising. Compared to the low-stable group, the early-rising group had significantly higher risks of recurrence (HR = 10.84, 95% CI: 5.57-21.10) and mortality (HR = 13.37, 95% CI: 5.45-32.81). The later-rising group had lower, but still significant, risks of recurrence (HR = 3.56, 95% CI: 1.62-7.81). Conclusion: Continuous postoperative monitoring of CEA levels in NSCLC patients is essential, especially for those with elevated postoperative CEA levels.
Keywords: Non-Small Lung Cancer, Curative resection, Carcinoembryonic Antigen, Perioperative Period, trajectories
Received: 12 May 2025; Accepted: 25 Sep 2025.
Copyright: © 2025 Ma, Pan, Cui, Lu, Sun, Pan, Xiao, Hu, Li, Tu and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huakang Tu, huakangtu@zju.edu.cn
Xifeng Wu, xifengw@zju.edu.cn
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