Clinical Impact of Intraoperative Detection of Carcinoembryonic Antigen mRNA in Pleural Lavage Specimens from Nonsmall Cell Lung Cancer Patients

Background The prospective trial of intraoperative detection of carcinoembryonic antigen mRNA (mCEA) in pleural lavage in patients undergoing resection for nonsmall cell lung cancers (NSCLCs) was undertaken to analyze clinical applicability. Methods From January 2006 to August 2008, cytology and mCEA analysis with pleural lavage were performed for 383 patients undergoing resection of NSCLCs. The pleural cavity was washed with 100 mL of physiological saline, and recovered lavage fluid was divided into two portions, one for pleural lavage cytology and the other for determination of mCEA expression by the transcription reverse transcription concerted reaction method. Results One hundred and nineteen (31%) cases were mCEA-positive. Positive mCEA results were observed frequently for adenocarcinoma patients and were recognized as a suggestive prognostic factor by stepwise regression analyses (p = 0.0472). The overall 4-year survival rate was 56% in the mCEA-positive group and 81% in the negative cases (p = 0.003). Of 71 cases suffering recurrence, it occurred frequently in mCEA-positive group (p = 0.035). Conclusion Intraoperative mCEA analysis may be a reliable indicator for assessing short-term prognosis and likelihood of early recurrence.