血清CEA水平与EGFR-TKI治疗晚期非小细胞肺癌疗效及预后分析

Serum CEA level is associated with efficacy and prognosis of EGFR-TKI treatment in non-small cell lung cancer:report of 88 cases

目的探讨非小细胞肺癌患者血清癌胚抗原(carcinoembryonic antigen,CEA)水平与EGFR-TKI治疗疗效及预后之间的关系。方法收集88例(腺癌69例,非腺癌19例)经吉非替尼或厄罗替尼治疗、疗效可评价的晚期非小细胞肺癌患者,有完整的血清CEA检测结果,分析CEA水平与EGFR-TKI药物治疗反应及预后之间的关系。结果血清CEA<5 ng/ml者的有效率(CR+PR)为18.2%(6/33),稳定率(SD)为18.2%(6/33),进展率为63.6%(21/33);CEA≥5 ng/ml者的有效率为30.9%(17/55),稳定率为43.6%(24/55),进展率为25.5%(14/55)。2组EGFR-TKI治疗的疗效差异有统计学意义(P=0.003)。血清CEA水平高的患者,服用TKI药物后疗效更好,而较低CEA值的患者效果较差。生存分析结果表明,血清CEA≥5 ng/ml组患者经EGFR-TKI治疗后有更长的无疾病进展时间及生存优势,差异有统计学意义(P=0.020,P=0.019)。结论血清CEA水平可作为预测晚期非小细胞肺癌患者服用EGFR-TKI药物疗效及预后指标。

Objective To identify the correlation of the serum carcinoembryonic antigen（CEA） level and the therapeutic effect of epidermal growth factor receptor tyrosine kinase inhibitor（EGFR-TKI） as a gene targeted drug in advanced non-small cell lung cancer（NSCLC）.Methods We retrospectively reviewed 88 NSCLC patients,including 69 adenocarcinoma and 19 non-adenocarcinoma who admitted in our hospitals from July 2007 to November 2010.After at least 1 cycle of chemotherapy,they begun to take Gefitinib or Erlotinib.Their therapeutic effect could be evaluated correctly and all cases had complete outcome of serum CEA.The statistical test between the serum CEA level and the therapeutic effect were performed by SPSS17.0.Results In the cases whose serum CEA level was lesser than 5 ng/ml,the effect rate（including complete remission and partial remission,CR ＋ PR） was 18.2%（6/33）,the stable disease（SD） rate was 18.2%（6/33） and the progressive disease（PD） rate was 63.6%（21/33）.But in the cases whose serum CEA level was equal or higher than 5 ng/ml,the effect rate（CR＋PR） was 30.9%（17/55）,the SD rate was 43.6%（24/55） and the PD rate was 25.5%（14/55）.The two EGFR-TKI treatment response rates had greatly statistical difference（P=0.003）.The patients who had a higher serum CEA level had a better therapeutic outcome,while for those with a low CEA level,a poor therapeutic effect was observed.Survival analysis suggested that high serum CEA level was associated with long progress free survival（PFS） and good prognosis（P=0.020,P=0.019）.Conclusion Serum CEA level can be regard as predictive factor for therapeutic effect and prognosis in advanced NSCLC treated with EGFR-TKI.