非小细胞肺癌患者血清CEA水平与EGFR-TKI疗效的关系

摘要

背景与目的:靶向治疗药物表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitors,EGFR-TKI)在晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者中的疗效预测评估成为近年来研究的热点之一.本研究旨在探讨NSCLC患者血清癌胚抗原(carcinoembryonic antigen,CEA)水平与EGFR-TKI治疗疗效的关系.方法:收集83例(腺癌67例,非腺癌16例)经吉非替尼或厄罗替尼治疗且疗效可评价的晚期NSCLC患者,有完整的血清CEA检测结果,分析CEA水平与EGFR-TKI药物治疗疗效的关系.结果:血清CEA<5 ng/mL者的有效率(CR+PR)为15.6%(5/32),疾病控制率(CR+PR+SD)为34.4%(11/32);CEA≥5 ng/mL者的有效率为29.4%(15/51),疾病控制率为74.5%(38/51).两组EGFR-TKI治疗的疗效差异有显著的统计学意义.血清CEA水平高的患者,服用EGFR-TKI药物后疗效更好,而CEA值较低的患者疗效较差.进一步分析血清CEA<5 ng/mL与CEA≥5 ng/mL患者一般临床特征,发现两组患者差异无统计学意义(P>0.05).结论:血清CEA水平可作为预测晚期NSCLC患者服用EGFR-TKI药物的疗效指标.%Background and purpose: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) has been used for advanced non-small cell lung cancer (NSCLC) as a gene targeting drug.This study investigated the relationship between serum CEA levels and its therapeutic effect in advanced NSCLC patients treated with EGFR-TKI.Methods: In this study, we reviewed 83 NSCLC patients who took EGFR-TKI, including 67 patients with adenocarcinoma and 16 non-adenocarcinoma.The therapeutic effects were evaluated and all cases had a complete outcome of serum CEA.The statistical test between serum CEA levels and therapeutic effects were performed by SPSS 17.0.Results: In the group where serum CEA level ＜5 ng/mL, the effect rate (CR+PR) was 15.6％ (5/32) and disease control rate was 34.4％ (11/32), but in the other group, the patients whose serum CEA level was ≥5 ng/mL, the effect rate (CR+PR) was 29.4％ (15/51) and disease control rate (CR+PR+SD) was 74.5％ (38/51).The patients with different CEA level received EGFR-TKI treatment had great statistical differences in response rates.Patients whose serum CEA levels ≥ 5 ng/mL had better therapeutic responses than ＜5 ng/mL group.Besides, the clinicopathological characteristics of the patients from the 2 groups were compared, but there was no significant difference.Conclusion: Serum CEA levels are clinically significance as a predictive factor for therapeutic effects in advanced NSCLC patients treated with EGFR-TKI.