晚期非小细胞肺癌外周血EGFR基因检测与肿瘤抗原标志物的临床意义

Relationship between serum tumor markers and EGFR gene mutation in plasma circulating DNA from NSCLC patients

目的探讨原发性非小细胞肺癌(NSCLC)患者的血液肿瘤抗原标志物和外周血浆EGFR基因突变的关系,研究其对靶向治疗的价值。方法选择NSCLC患者66例,无创检测外周血浆标本EGFR基因突变和血液肿瘤抗原标志物水平,评价两者的关系及临床意义。结果本研究中NSCLC患者的EGFR基因突变率为43.94%。EGFR基因突变多发患者群为女性、非吸烟及肺腺癌(P<0.05),与年龄及肿瘤分期无显著相关性(P>0.05)。血浆EGFR基因突变阳性的患者血CEA水平比无EGFR基因突变的患者高,而SCCAg的水平比无EGFR基因突变的患者低,差异有统计学意义(P<0.05),其余指标NSE,Ca125,Cyfra21-1在EGFR基因突变型和野生型患者的比较中差异无统计学意义(P>0.05)。结论对于血液中CEA升高和SCCAg降低的晚期NSCLC患者EGFR基因突变发生的可能性较大,选择这些患者行血浆EGFR基因检测无创安全且对靶向治疗有一定的指导意义。

Objective To investigate the relationship between serum tumor markers and plasma epidermal growth factor （EGFR） gene mutation in patients with non-small cell lung cancer （NSCLC） and to explore its prog- nostic value. Methods The serum EGFR gene mutation and serum tumor markers of 66 NSCLC patients were detec-ted, and the relationship between EGFR gene mutation and serum tumor markers was analyzed. Results 66 NSCLC patients were enrolled, and the mutation rate was 43.94%. EGFR gene mutation was mainly occurred in women, non-smoking and adenocarcinoma patients （P 〈 0. 05）. When the serum CEA was elevated or the serum SCCAg de- creased, EGFR mutation rate increased significantly （ P 〈 0. 05 ）. While there was no correlation between NSE, CA125, CYFRA21-1 and EGFR gene mutation （P 〉 0.05 ）. Conclusion For the patients whose EGFR gene muta- tion can not be tested, we can chose those with low serum SCCAg and high CEA, and according to their clinical char- acteristics, they will be given EGFR-TKIs treatment and EGFR gene mutation detection.