Prognostic factors in patients with small cell lung cancer

Objective To investigate the prognostic factors of small cell lung cancer (SCLC) and establish a reliable model of clinical prognostic index. Methods Kaplan-Meier and Cox regression were used to analyze the relationship betw een survival time and prognostic factors in 60 cases of SCLC. The prognostic fac tors included clinical and laboratory parameters,serum cytokeratin fragment 19 (CYFRA21-1),carcinoembryonic antigen (CEA),neuron-specific enolase (NSE),CA 125,interleukin-2 (IL-2) and soluble interleukin-2 receptors (sIL-2R). Results Kaplan-Meier analysis showed that poor prognosis was in patients with KPS80 or extensive disease and unrelated to other clinical parameters such as age,sex an d smoking index,and in patients with serum NSE30 μg/L,CEA5.0 μg/L, CA12537 KU/L and sIL-2R500 KU/L. Serum IL-2 and CYFRA21-1 were also elev ated,but had no significant prognostic value. Multivariate analysis indicated t hat serum NSE,stage and treatment of disease were independent prognostic factor s. The three prognostic factors enabled establishment of a prognostic index (PI) based on a simple algorithm: PI = NSE (0 if≤30 μg/L,1 if 30 μg/L) + stage(0=LD,1=ED) + CEA(0 if ≤ 5.0 μg/L,1 if 5.0 μg/L). Conclusion The stage of disease,systemic treatment and the level of serum NSE are indepe ndent prognostic factors. Without considering the influence of treatment-relate d factors on survival,the levels of serum CEA,NSE and stage of disease before t reatment are significant independent prognostic factors. PI calculated on the ba sis of CEA,NSE and stage is recommended to predict the survival of SCLC.