血清CEA和LDH对肺腺癌靶向治疗疗效和预后的评价作用

Predictive and prognostic significance of CEA and LDH in lung adenocarcinoma patients receiving targeted therapy

目的分析治疗前血清癌胚抗原(CEA)和乳酸脱氢酶(LDH)对接受酪氨酸激酶抑制剂(TKIs)靶向治疗的肺腺癌患者疗效和预后的评价作用。方法回顾性收集45例接受表皮生长因子受体(EGFR)TKIs治疗的肺腺癌患者的完整临床资料,分析CEA、LDH与EGFR-TKI治疗疗效和无进展生存期(PFS)的关系。结果以正常值为截点,治疗前血清CEA值正常9例,升高36例,两组控制率分别为44.4%、83.3%,差异有统计学意义(P=0.028)。治疗前血清LDH是否升高与治疗疗效无显著影响(P>0.05)。生存分析结果显示:治疗前CEA值升高、EGFR突变患者的中位PFS显著延长(P=0.010、0.005),EGFR突变状态、治疗前LDH水平是影响患者PFS的独立因素(P=0.009、0.017)。结论治疗前血清CEA、LDH水平对肺腺癌TKIs靶向治疗患者的疗效和预后的评估有重要的参考价值。

Objective To investigate the predictive and prognostic significance of CEA and LDH in lung adenocarcinoma patients receiving targeted therapy with TKIs. Methods The clinical data of 45 lung adenocarcinoma patients treated with epidermal growth factor receptor tyrosine-kinase inhibitor（ EGFR-TKI） were collected,their serum CEA and LDH levels were detected to evaluate efficacy and prognosis. Results Taking normal value as the cutoff point,the level of serum CEA was normal in 9 cases and increased in 36 cases,and the control rate was 44. 4%and 83. 3%（ P = 0. 028）. There was no significant correlation between pre-treatment serum LDH and the therapeutic effect（ P〉 0. 05）. Survival analysis showed that patients with high pre-treatment serum levels of CEA and EGFR mutation had longer m PFS（ P = 0. 010,0. 005）. Multivariate cox regression analysis showed that EGFR mutation status and LDH levels before treatment were both independent factors for PFS（ P = 0. 009,0. 017）. Conclusion The pre-treatment serum levels of CEA and LDH may have important clinical significance for prediction the efficacy and prognosis in lung adenocarcinoma patients receiving targeted therapy with EGFR-TKI.