Association of neurologic manifestations and CEA levels with the diagnosis of brain metastases in lung cancer patients

• B. Cacho-Díaz ^[1] ; H. Spínola-Maroño ^[1] ; L. G. Mendoza-Olivas ^[1] ; A. Monroy-Sosa ^[1] ; G. Reyes-Soto ^[1] ; O. Arrieta ^[2]
  1. [1] Neuro-Oncology Unit, National Cancer Institute, Mexico
  2. [2] Thoracic Oncology Unit, National Cancer Institute, Mexico
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 21, Nº. 11, 2019, págs. 1538-1542
• Idioma: inglés
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• Resumen

  • Purpose Lung cancer (LC) is the most common source of brain metastases (BM). Because of the difficulty in predicting LC patients who will develop BM, we aimed to identify the clinical and serologic markers that could predict the presence of BM in LC patients.

    Methods We analyzed a cohort of LC patients sent for neurooncological consultation for any neurologic symptom at a cancer center from June 2013 to July 2017. Inclusion criteria: histologically confirmed LC, age ≥ 18 years and complete clinical records. Exclusion criteria: BM diagnosis before our consultation and absence of MRI. Oncologic history, clinical symptoms and comorbidities were analyzed.

    Results From 199 patients, most (70%) had > 1 neurological symptom. The most common was headache (n = 46, 21%), followed by seizures (17%), altered mental status (16%) and focal motor weakness (13%). BM was found in 74% of the patients during follow-up. Multivariate logistic regression analysis showed factors associated with a higher frequency of BM: age < 65 years [OR 3.15, 95% CI 1.3–7.5], headache (OR 3.8, 95% CI 1.2–11.8), seizures (OR 3.2, 95% CI 1.1–9.3) and CEA ≥ 15 ng/mL (OR 5.5, 95% CI 2.2–13.8). Focal sensory deficit was associated with a lower frequency of BM (OR 0.2, 95% CI 0.06–0.92). The presence of certain clinical neurologic symptoms, together with CEA level, was associated with a higher risk of BM in LC patients.

    Conclusion The clinical manifestations of patients with LC should not be overlooked because some may have a substantial correlation with BM.