Objective  To investigate the relationship between serum carcinoembryonic antigen (CEA) and the predictive value of epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer patients, as well as to analyze further EGFR mutations and CEA levels affecting patient survival.

  Methods  From March 2009 to March 2011, a total of 387 cases were treated in the Lung Cancer Department in Tianjin Cancer Hospital. Preoperative CEA tumor marker and postoperative EGFR gene mutation were used for routine detection. The influence of CEA tumor marker on EGFR mutation and its relationship with the prognosis were analyzed further.

  Results  A total of 168 cases involved EGFR mutations, the incidence of which is more frequent in women, non-smokers, adenocarcinoma patients, and patients below 60 years old (P < 0.05). This study also determined that EGFR mutation was related with tumor markers and chemosensitivity indicators. Elevated Cyfra21-1, SCC, and ERCC1-positive are more common in wild-type patients (P < 0.05). However, abnormal CEA was more common in EGFR mutation patients (P=0.015). The rate of EGFR gene mutations significantly increased as the serum CEA level increased. Serum CEA levels were divided into three groups (< 5, 5-20, and >20). The positive rates of EGFR mutations were 40.1%, 47.5% and 66.6% (P=0.003). Logistic regression analysis determined that CEA levels are independent factors in predicting EGFR mutations and independent prognostic factors in patients with non-small cell lung cancer.

  Conclusion  Serum CEA levels can independently predict the prognosis of resected non-small cell lung cancer patients, which is has a close relationship with EGFR mutations.