肺腺癌患者表皮生长因子受体基因突变与肿瘤标志物关系研究

The relationship between EGFR gene mutation and serum tumor markers in lung adenocarcinoma patients

目的探讨肺腺癌患者表皮生长因子受体(EGFR)基因突变与血清肿瘤标志物之间的关系。方法选择2015年1月至2017年12月,中国医科大学附属第四医院胸外科肺腺癌患者资料97例。采用化学发光免疫法检测患者血清各肿瘤标志物水平,并对检测结果进行统计学分析。结果女性患者EGFR基因突变率高于男性患者,非吸烟患者高于吸烟患者,差异有统计学意义(均P<0. 001)。而年龄、肿瘤分期对EGFR基因突变率无影响,差异无统计学意义(P>0. 05)。血清癌胚抗原(CEA)水平异常组EGFR基因突变率高于正常组,差异有统计学意义(P<0. 05);当50μg/L<CEA<100μg/L时,EGFR基因突变率最高(77%)。血清细胞角蛋白19片段(CYFRA21-1)浓度,正常组患者EGFR基因突变发生率高于异常组,差异有统计学意义(P<0. 05),而神经元特异性烯醇化酶(NSE)、CA125、CA153和CA19-9正常组与对应的异常组EGFR基因突变率差异无统计学意义(P> 0. 05)。ROC曲线显示,血清CEA、CYFRA21-1水平预测EGFR基因突变的曲线下面积分别为0. 740、0. 609。结论肺腺癌患者女性、非吸烟患者更容易发生EGFR基因突变,血清肿瘤标志物CEA、CYFRA21-1水平对预测EGFR基因突变有一定价值。

Objective To explore the correlation between EGFR gene mutations and serum tumor markers in lung adenocarcinoma patients.Methods A total of97patients with pathologically confirmed lung adenocarcinoma concurrent EGFR gene detection were collected from January2015to December2017in our hospital.Serum levels of each tumor marker were measured by chemiluminescence immunoassay and the clinical features of EGFR gene mutation patients were analyzed.Results The EGFR gene rate was higher in female patients than that in male patients,and the non-smoking patients were higher than smoking patients(P<0.001),but there was no statistical difference in the age and tumor stage of the patients(P>0.05).Patients with increased serum CEA level had higher EGFR gene mutation rate than that in the normal group(P<0.05),and the mutation rate was the highest(77%)when50μg/L<CEA<100μg/L;The incidence of EGFR gene mutation in patient with normal CYFRA21-1concentration was higher than that in the increased group(P<0.05),while there was no significant difference in the mutation rate of EGFR gene between the normal concentration group of NSE,CA125,CA153and CA19-9and the corresponding abnormal group(P>0.05).The results of ROC curve showed that the areas under the curve of serum CEA and CYFRA21-1predicted EGFR gene mutation were0.740and0.609,respectively.Conclusions In patients with lung adenocarcinoma,female and non-smoking patients are more likely to have EGFR gene mutations.Serum tumor markers CEA and CYFRA21-1have a certain correlation with EGFR gene mutation,which is of certain value for predicting EGFR gene mutation.