血清CEA水平与EGFR基因突变在首次复发的晚期非小细胞肺癌中的相关性

Relationship between serum carcinoembryonic antigen and EGFR mutation in recurrent non-small cell lung cancer

目的:探讨首次复发的晚期NSCLC EGFR基因突变率与临床基线特征和血清CEA表达水平之间的关系。方法:收集治疗后首次复发的晚期NSCLC患者102例,ADx-ARMS法检测患者组织标本中EGFR 29种突变,电化学发光法检测血清CEA水平。结果:102例复发的晚期NSCLC患者中,EGFR总突变率为60.8%,其中女性显著高于男性(χ2=11.868,P=0.001);腺癌高于其他组织学类型(χ2=6.002,P=0.014);非吸烟患者显著高于吸烟患者(χ2=8.502,P=0.004);血清CEA≥5.0 ng/mL时显著高于血清CEA<5.0 ng/mL(χ2=22.543,P=0.000)。多变量Logistic分析发现首次复发时血清CEA表达水平与EGFR基因突变呈正相关(P=0.002)。结论:对于首次复发的晚期NSCLC,EGFR突变率与血清CEA的表达水平明显相关,血清CEA表达水平是EGFR基因突变的独立预测因素。血清CEA水平可作为难以获得组织的复发的晚期NSCLC患者判断EGFR基因突变的一种参考因素。

Objective To investigate the relationship of epidermal growth factor receptor （EGFR） mutation with clinical features of baselines as well as serum CEA level in patients with recurrent non-small cell lung cancer （NSCLC）. Methods A total of 54 patients with first recurrence of advanced lung cancer who had received chemotherapy were included in this study. ADx-ARMS was performed to detect EGFR gene mutations in surgical specimens taken from the primary tumor. Serum CEA level was measured by the electrochemical luminescence method. Results The mutation rate of EGFR was significantly higher in females than in males （χ2= 11.868, P =0.006）, with a total mutation rate of 60.8%in 106 patients. The rate was higher in adenocarcinoma than in other histological types（χ2=6.002,P=0.014）, and significantly higher in non-smokers than in smokers （χ2= 8.502,P=0.004） and in the patients with serum CEA level over or equal to 5.0 ng/mL than those with CEA level less than 5.0 ng/mL （χ2=22.543,P=0.000）. A multivariate analysis revealed that a higher serum CEA level at the time of disease recurrence was associated with EGFR gene mutations （P = 0.002）. Conculsions Serum CEA level is closely associated with the presence of EGFR gene mutations in patients with first recurrence of advanced NSCLC. A higher serum CEA level at the time of disease recurrence is independently associated with EGFR gene mutations. CEA level can be used as a potential indicator to determine EGFR mutation.