表皮生长因子受体突变肺腺癌患者血清肿瘤标志物水平及与临床疗效的关系

Assocition between serum tumor markers and clinical efficacy in patients with EGFR mutation

目的探讨表皮生长因子受体(EGFR)突变肺腺癌患者血清癌胚抗原(CEA)、糖类抗原19-9(CA19-9)水平及与疗效的关系。方法回顾性选取2017年1月至2020年1月间东阿县人民医院收治的EGFR突变肺腺癌患者97例(EGFR突变组),同时选取EGFR未突变患者100例作为对照(EGFR未突变组),比较两组患者的血清CEA及CA19-9水平。EGFR突变组患者采用靶向治疗,观察CEA、CA19-9水平与治疗疗效及预后的关系。结果EGFR突变组患者CEA>5ng/L比例高于EGFR未突变组,差异有统计学意义(P<0.05);两组CA19-9>34U/ml比例比较,差异无统计学意义(P>0.05)。EGFR突变组经靶向治疗后53例患者获部分缓解(PR),33例患者获稳定(SD),11例患者获进展(PD)。完全缓解+PR组和SD+PD组患者的性别、年龄、吸烟史、CEA>5ng/L和CA19-9>34U/ml比例比较,差异均无统计学意义(P>0.05);CR+PR组临床分期ⅢB期和高分化比例高于SD+PD组,差异均有统计学意义(均P<0.05)。CEA>5ng/L和CEA≤5ng/L患者中位无进展生存时间分别为13个月和14个月,差异无统计学意义(P>0.05)。CEA>5ng/L患者中位总体生存时间为20个月,少于CEA≤5ng/L患者的30个月,差异有统计学意义(P<0.05)。CA19-9>34U/ml和CA19-9≤34U/ml患者中位无进展生存时间分别为13个月和14个月,中位总体生存时间分别为20个月和24个月,差异均无统计学意义(均P>0.05)。结论CEA与EGFR突变肺腺癌患者总体生存时间有一定关系,CA19-9与患者预后无明显关系。

Objective To investigate the association between serum carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels and clinical efficacy in patients with epidermal growth factor receptor(EGFR)mutated lung adenocarcinoma.Methods Ninety-seven patients with EGFR mutated lung adenocarcinoma were selected(EGFR mutation group)and 100 patients without EGFR mutation were selected and included in a control group(nonmutation group)at Donge County People’s Hospital from January 2017 to January 2020.The serum CEA and CA19-9 levels were compared between the two groups.EGFR mutated lung adenocarcinoma patients were given targeted therapy.The association between CEA,CA19-9 levels and treatment efficacy and prognosis was observed.Results The proportion of patients with CEA>5 ng/L was higher in the mutation group than in the nonmutation group(P<0.05).There was no significant difference in the proportion of patients with CA19-9>34 U/ml between the mutation group and nonmutation group(P>0.05).No patient achieved complete response(CR),53 patients achieved partial response(PR),33 patients achieved disease stabilization(SD)and 11 patients developed disease progression(PD)in the mutation group.There was no statistically significant differences in gender,age,smoking history,and the proportion of patients with CEA>5 ng/L and CA19-9>34 U/ml between CR+PR subgroup and SD+PD subgroup(P>0.05).The proportion of patients with clinical stagesⅢB cancer and high differentiation rate were significantly higher in the CR+PR subgroup than in the SD+PD subgroup(all P<0.05).The median progression free survival was 13 months and 14 months,respectively in patients with CEA>5 ng/L and patients with CEA≤5 ng/L(P>0.05).The median overall survival was 20 months in patients with CEA>5 ng/L which was lower than 30 months of patients with CEA≤5 ng/L(P<0.05).The median progression free survival was 13 months and 14 months,respectively and the median overall survival was 20 months and 24 months,respectively in patients with CA19-9>34 U/ml and CA19-9≤34 U/ml(all P<0.05).Conclusion Serum CEA is associated with overall survival in patients with EGFR mutated lung adenocarcinoma.However,CA19-9 does not have a significant effect on prognosis.