Prognostic significance of preoperative serum carcinoembryonic antigen in non-small cell lung cancer: a meta-analysis

Observational studies on the prognostic role of preoperative serum carcinoembryonic antigen (CEA) in non-small cell lung cancer (NSCLC) are controversial. Electronic databases updated until June 1, 2014 were searched to find relevant studies. A meta-analysis was conducted with eligible studies which quantitatively evaluated the relationship between preoperative serum CEA level and survival of patients with NSCLC. Survival data were aggregated and quantitatively analyzed. We performed a meta-analysis of 16 studies (n = 4,296 patients) that evaluated the correlation between preoperative serum CEA level and survival in patients with NSCLC. Combined hazard ratios suggested that preoperative serum CEA overexpression was associated with poor prognosis of overall survival (OS) (hazard ratio (HR) = 2.28, 95 % confidence interval (CI) 2.24–2.31) in patients with NSCLC. Meanwhile, for p-stage I NSCLC, the HR (95 % CI) was 1.98 (1.73–2.15). In the stratified analysis by patient source, significant risks were found among Asians and non-Asians. However, significant heterogeneity was observed among all studies. In the present meta-analysis, preoperative serum CEA overexpression indicates a poor prognosis for patients with NSCLC.