[1]王翠翠,耿利民△.血清癌胚抗原对表皮生长因子受体基因突变非小细胞肺癌分子靶向治疗疗效的预测价值[J].陕西医学杂志,2020,49(7):834-837.[doi:DOI:10.3969/j.issn.10007377.2020.07.018]
　WANG Cuicui,GENG Limin..Predictive value of serum CEA in molecular targeted therapy of non-small cell lung cancer patients with EGFR gene mutation[J].,2020,49(7):834-837.[doi:DOI:10.3969/j.issn.10007377.2020.07.018]
点击复制

血清癌胚抗原对表皮生长因子受体基因突变非小细胞肺癌分子靶向治疗疗效的预测价值
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年7期
页码:
834-837
栏目:
临床研究
出版日期:
2020-07-05

文章信息/Info

Title:
Predictive value of serum CEA in molecular targeted therapy of non-small cell lung cancer patients with EGFR gene mutation
作者:
王翠翠1; 耿利民2△
1.陕西省渭南市中心医院(渭南714000); 2.陕西省安康市中心医院(安康725000)
Author(s):
WANG Cuicui; GENG Limin.
Weinan Central Hospital,Shaanxi Province(Weinan 714000)
关键词:
癌胚抗原;  表皮生长因子受体;  表皮生长因子受体酪氨酸激酶抑制剂;  非小细胞肺癌;  分子靶向治疗
Keywords:
Carcinoembryonic antigen;  Epidermal growth factor receptor;  Epidermal growth factor receptor-tyrosine kinase inhibitor;  Non-small cell lung cancer;  Molecular targeted therapy
分类号:
R734.2
DOI:
DOI:10.3969/j.issn.10007377.2020.07.018
文献标志码:
A
摘要:
的:探讨血清癌胚抗原(CEA)对表皮生长因子受体(EGFR)基因突变非小细胞肺癌(NSCLC)患者分子靶向治疗疗效的预测价值。方法:选择EGFR基因突变的晚期NSCLC患者82例为研究对象,纳入的患者均给予表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)治疗,分析血清CEA水平在预测此类患者经EGFR-TKIs治疗的疗效和预后的价值。结果:82例患者EGFR-TKIs治疗的有效率为30.49%(25/82),控制率为64.63%(53/82)。与治疗前比较,完全缓解(CR)+部分缓解(PR)患者经治疗后的血清CEA水平明显降低(P<0.05),进展(PD)患者经治疗后血清CEA水平明显增加(P<0.05),稳定(SD)患者则未见明显变化(P>0.05)。不同性别、年龄、吸烟史、病理类型、临床分期、ECOG体能状态评分、治疗药物、治疗线数的患者近期疗效比较差异无统计学意义(P>0.05)。治疗前基线CEA≥5 ng/ml的NSCLC患者临床疗效显著高于CEA<5 ng/ml者,差异无统计学意义(P>0.05)。采用Kaplan-Meier法绘制的无进展生存时间(PFS)曲线显示,CEA≥ 5 ng/ml组与CEA<5 ng/ml组PFS分别为12.14个月(95%CI:6.53～21.20个月)和8.45个月(95%CI:5.20～15.71个月),两组经Log-rank检验比较差异有统计学意义(P<0.05)。结论:治疗前基线血清CEA水平越高则预示着EGFR基因突变的晚期NSCLC患者经EGFR-TKIs治疗的疗效越好,可作为此类分子靶向治疗疗法和预后的预测指标。
Abstract:
Objective:To explore the predictive value of serum carcinoembryonic antigen(CEA)in molecular targeted therapy of non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)gene mutation. Methods:82 patients with advanced NSCLC who had EGFR gene mutation were selected as the study subjects. All the patients were treated with epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs). The value of serum CEA level in predicting the efficacy and prognosis of these patients treated with EGFR-TKIs was analyzed. Results:The effective rate of EGFR-TKIs was 30.49%(25/82)and the control rate was 64.63%(53/82). Compared with the serum CEA level before treatment,that of CR and PR patients after treatment was decreased significantly(P<0.05),while that of PD patients was increased significantly(P<0.05),while that of SD patients did not change significantly(P>0.05). There was no significant difference in the short-term efficacy among the patients with different gender,age,smoking history,pathological type,clinical stage,ECOG physical fitness score,treatment drugs and treatment lines(P>0.05). The clinical efficacy of NSCLC patients with baseline CEA≥5 ng/ml before treatment was significantly higher than that of patients with CEA<5 ng/ml,but there was no significant difference(P>0.05). The PFS curve drawn by Kaplan-Meier method showed that the PFS of CEA≥5 ng/ml group and CEA<5 ng/ml group were 12.14 months(95% CI:6.53-21.20 months)and 8.45 months(95% CI:5.20-15.71 months),respectively,with statistically significant difference(P<0.05). Conclusion:The higher the baseline serum CEA level before treatment indicates the better efficacy of EGFR-TKIs in advanced NSCLC patients with EGFR gene mutation,which can be used as a predictor of molecular targeted therapy and prognosis.

参考文献/References:

[1] Lee CK,Man J,Lord S,et al. Checkpoint Inhibitors in metastatic EGFR-mutated non-small cell lung cancer-a meta-analysis[J]. J Thorac Oncol,2017,12(2):403-407.
[2] Sheng Z,Zhang Y. The efficacy of epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer harboring wild-type epidermal growth factor receptor:a meta-analysis of 25 RCTs[J]. Am J Clin Oncol,2017,40(4):362-369.
[3] 倪莲芳,聂立功.第三代EGFR-TKIs耐药之初探[J].中国肺癌杂志,2018,21(2):110-115.
[4] Zhao XM,Zhao J,Xing KL,et al. Prognostic and predictive value of serum carcinoembryonic antigen levels in advanced non-small cell lung cancer patients with epidermal growth factor receptor sensitive mutations and receiving tyrosine kinase inhibitors[J]. Oncotarget,2017,8(41):70865-70873.
[5] 中国非小细胞肺癌患者表皮生长因子受体基因突变检测专家组.中国非小细胞肺癌患者表皮生长因子受体基因突变检测专家共识(2016版)[J].中华病理学杂志,2016,45(4):217-220.
[6] 陆 舜. 非小细胞肺癌[M].北京:人民卫生出版社,2016:65-66.
[7] Shi Y,Au JS,Thongprasert S,et al. A prospective,molecular epidemiology study of EGFR mutation in Asian patients with advanced non-small-cell lung cancer of adenocarcinoma histology(PIONEER)[J]. J Thorac Oncol,2014,9(2):154-162.
[8] 王 宇,于丽艳,方 楠,等.中国人群非小细胞肺癌的基因突变情况及其靶向药物的应用[J].中华医学遗传学杂志,2019,36(5):424-428.
[9] Galli G,Corrao G,Imbimbo M,et al. Uncommon mutations in epidermal growth factor receptor and response to first and second generation tyrosine kinase inhibitors:A case series and literature review[J]. Lung Cancer,2018,115(10):135-142.
[10] Pilotto S,Rossi A,Vavalà T,et al. Outcomes of first-generation EGFR-TKIs against Non-Small-Cell lung cancer harboring uncommon EGFR mutations:a post hoc analysis of the BE-POSITIVE study[J].Clin Lung Cancer,2018,19(1):93-104.
[11] 倪 军,郭子健,张 力. 单独与联合检测四项肺癌血清肿瘤标志物在肺癌诊断中的价值[J]. 中华内科杂志,2016,55(1):25-30.
[12] 孙洪帅,朱 华,高海燕,等.肿瘤标志物SCC-Ag、CEA、CYFRA21-1和D-二聚体联合检测对非小细胞肺癌的早期诊断价值[J].吉林大学学报:医学版,2018,44(5):1020-1024.
[13] 隋东江,王蓉美,李海燕.EGFR-TKI治疗对NSCLC患者血清CEA的影响[J].癌症进展,2017,15(8):923-925.
[14] 陈绍森,邹 林,卢正亮,等. 血清癌胚抗原水平与免疫组化指标对肺癌患者EGFR基因突变的预测价值[J]. 广东医学,2018,39(14):2200-2203.
[15] 李晓琳,赵 月,马 婧,等.非小细胞肺癌肿瘤标志物联合检测在诊断中的意义及其对EGFR突变的预测价值[J].肿瘤药学,2019,9(4):607-611.

相似文献/References:

[1]侯洁心 ,郭萍△.免疫组化标志物Her2和肿瘤标志物在胃癌诊断中的价值分析*[J].陕西医学杂志,2019,(1):121.
　HOU Jiexin,GUO Ping..The value of immunohistochemical marker Her2 andtumor markers in the diagnosis of gastric cancer[J].,2019,(7):121.
[2]王 玲,申 鸿.癌胚抗原、糖类抗原、CA125、血管生成素、细胞角蛋白19片段及甲胎蛋白检测在肺癌诊断中的临床研究*[J].陕西医学杂志,2019,(8):1080.
　WANG Ling,SHEN Hong..The value of tumor markers CEA，CA199，CA125，Ang-2，CYFRA211 and AFP in the diagnosis of lung cancer[J].,2019,(7):1080.
[3]王群拴,黎小花△.核磁共振结合血清肿瘤标志物及细胞因子检测在〖JZ〗乳腺癌诊断中的应用价值研究*[J].陕西医学杂志,2019,(10):1295.
[4]王 徽,白玉勤.肺腺癌移植瘤裸鼠模型侵袭组织中酪氨酸蛋白激酶受体A7、表皮生长因子受体和Ki67蛋白表达及意义[J].陕西医学杂志,2021,50(9):1060.[doi:DOI:10.3969/j.issn.1000-7377.2021.09.005]
　WANG Hui,BAI Yuqin.Expression and significance of EphA7,EGFR and Ki67 proteins in invasion tissues of lung adenocarcinoma transplanted tumor in nude mice[J].,2021,50(7):1060.[doi:DOI:10.3969/j.issn.1000-7377.2021.09.005]
[5]徐英杰,李 巍.三阴性乳腺癌早期患者雄激素受体、Ki67、p53、表皮生长因子受体表达水平及其与临床病理特征关系研究[J].陕西医学杂志,2021,50(12):1594.[doi:DOI:10.3969/j.issn.1000-7377.2021.12.032]
　XU Yingjie,LI Wei.Expression levels of androgen receptor,Ki67,p53,epidermal growth factor receptor and their relationship with clinicopathological characteristics in early stage triple-negative breast cancer patients[J].,2021,50(7):1594.[doi:DOI:10.3969/j.issn.1000-7377.2021.12.032]
[6]董佳鑫,王海艳,NOUTCHIE VINYE Nana(喀麦隆),等.幽门螺杆菌感染致表皮生长因子及其受体表达上调与胃癌发生及发展机制关系研究进展[J].陕西医学杂志,2024,(6):853.[doi:DOI:10.3969/j.issn.1000-7377.2024.06.028]
　DONG Jiaxin,WANG Haiyan,NOUTCHIE VINYE Nana,et al.Research progress on relationship between up-regulation of EGF/EGFR expression caused by Helicobacter pylori and mechanism of gastric cancer development[J].,2024,(7):853.[doi:DOI:10.3969/j.issn.1000-7377.2024.06.028]

更新日期/Last Update: 2020-07-28