首诊非小细胞肺癌患者癌胚抗原与表皮生长因子受体突变状态相关性分析

Analysis of Commodity Exchange Authority and Epidermal Growth Factor Receptor Mutations Correlation in the Primary Non-small Cell Lung Cancer

目的分析首诊初治非小细胞肺癌患者表皮生长因子受体(EGFR)突变状态与血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19可溶性片段21-1(CYFRA 21-1)水平的相关性,寻找可能作为预测EGFR突变人群的最简单廉价的血清学指标。方法应用血清化学发光法动态监测患者外周血CEA、NSE、CYFRA21-1水平,应用扩增阻碍突变系统方法检测同一患者组织EGFR突变状态,并对EGFR突变状态及患者肿瘤标志物水平进行统计学分析。结果关联性分析显示,EGFR突变与性别、吸烟、病理类型、CEA水平、CYFRA21-1水平有关(P<0.05)。非条件Logistic回归分析结果显示,性别和CEA与EGFR突变相关(P<0.05)。CEA升高患者较CEA正常患者EGFR突变的可能性更大,并且EGFR突变率随着CEA的升高而增加(P<0.05)。CEA检测对EGFR突变预测的AUC>0.7。结论在其他因素不变的情况下,EGFR突变优势人群筛选为亚裔、女性、非吸烟、肺腺癌且初始血清CEA水平较高患者,CEA检测对EGFR突变预测的诊断价值中等。

Objective To analyze the correlation of epidermal growth factor receptor(EGFR) mutation status and serum commodity exchange authority(CEA),neuron-specific enolase(NSE),cytokeratins21-1(CYFRA21-1) level in the primary non-small cell lung cancer.Methods Chemiluminescence method was used for the dynamic monitoring of peripheral blood serum CEA,NSE,CYFRA21-1 levels in the patients with primary non-small cell lung cancer,amplification-refractory mutation system method was applied to detect the same tissue in patients with EGFR mutations,and levels of tumor markers in patients with EGFR mutations was analyzed.Results EGFR mutations in the correlation analysis was related with gender,smoking,pathological type,initial CEA level,CYFRA21-1 level(P<0.05).The results of non-conditional Logistic regression analysis showed that CEA and gender were related with EGFR mutation(P<0.05).The EGFR mutation incidence in the patients with CEA increase was higher than that patients with CEA normal.The AUC of CEA was >0.7 in the EGFR mutation prediction.Conclusion Under the condition of the other factors unchanged,EGFR mutations advantage population screening for asians,women,no smoking,lung adenocarcinoma and patient with higher initial serum CEA level,CEA detection has the medium diagnostic value for EGFR mutations.